lutetium lu-177 vipivotide tetraxetan

High Alert

Prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer in patients who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy.

Contraindicated in:

None.

Use Cautiously in:

Renal impairment;
Rep: Men with female partners of reproductive potential;
Geri: ↑risk of adverse reactions in older adults.

CV: peripheral edema

F and E: hyperkalemia, hypernatremia, hypocalcemia, hyponatremia

GI: ↑liver enzymes, abdominal pain, constipation, diarrhea, dry mouth, nausea, vomiting

GU: ↑serum creatinine, urinary tract infection, acute kidney injury, infertility

Hemat: anemia, leukopenia, lymphopenia, neutropenia, thrombocytopenia

Metab: ↓appetite, weight loss

Neuro: fatigue, dizziness, dysgeusia, headache

Misc: fever

Drug-drug:

None reported.

Solution for injection: 27 mCi/mL

IV (Adults ): 7.4 GBq (200 mCi) every 6 wk for up to 6 doses or until disease progression or unacceptable toxicity.

Pluvicto

The radionuclide lutetium-177 is linked to a moiety that binds to PSMA, which is highly expressed on prostate cancer cells. Once bound to PSMA, lutetium-177 is internalized and then emits beta radiation, which leads to cellular damage/death in PSMA-positive cells.

Therapeutic effects:

Improvement in overall survival and progression-free survival.

Therapeutic Classification: antineoplastics

Pharmacologic Classification: radiopharmaceuticals

Absorption: IV administration results in complete bioavailability.

Distribution: Extensively distributed to tissues.

Metabolism/Excretion: Does not undergo hepatic metabolism. Primarily excreted in urine.

Half-Life: 41.6 hr.

(blood concentrations)

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	unknown

Explain purpose and side effects of lutetium lu-177 vipivotide tetraxetan to patient. Advise patient to hydrate adequately and urinate frequently before and after treatments to reduce bladder radiation. Advise patient to read Patient Information before starting therapy.
Advise patient that use contributes to cumulative radiation exposure, which is associated with ↑ risk of cancer. Advise patients of radioprotection instructions to follow at home.
Advise patient to limit close contact (<3 feet) with household contacts for 2 days or with children and pregnant women for 7 days after administration. Tell patient to sleep in a separate bedroom from household contacts for 3 days, from children for 7 days, or from pregnant women for 15 days after administration.
Instruct patient to refrain from sexual activity for 7 days.
Counsel patient to report symptoms of renal toxicity (↓ urination, flank pain, fatigue, nausea, vomiting, fluid retention).
Counsel patient to report symptoms of myelosuppression (fatigue, shortness of breath, dizziness, fast or irregular heartbeat, tinnitus, headache, pale skin, chest pain).
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications.
Rep: May cause fetal harm. Advise male patients with female partners of reproductive potential to use effective contraception during treatment and for 14 wk after the last dose. May cause temporary or permanent infertility in men.

loo-TEE-shee-um loo 177 vye-PIV-oh-tide te-TRAX-e-tan

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Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

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US Brand Names ⬆ ⬇

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Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆