Pluvicto
Pluvicto (lutetium lu 177 vipivotide tetraxetan) is a radiopharmaceutical that’s used to treat adults with certain castration-resistant prostate cancers that have spread to other parts of the body. It targets cancer cells that have a particular protein on their surface. It’s typically given as an injection through the vein every 6 weeks for up to 6 doses. Talk with your treatment team about keeping yourself and others safe after each treatment because you could expose others to radiation for a few days after each dose. Common side effects include fatigue, nausea, dry mouth, and constipation.
What is Pluvicto (lutetium lu 177 vipivotide tetraxetan)?
What is Pluvicto (lutetium lu 177 vipivotide tetraxetan) used for?
Metastatic castration-resistant prostate cancer that’s positive for PSMA, after using androgen receptor pathway blocker and taxane chemotherapy treatments
How Pluvicto (lutetium lu 177 vipivotide tetraxetan) works
Pluvicto (lutetium lu 177 vipivotide tetraxetan) is a radiopharmaceutical. It attaches a particular protein found on the surface of certain cancer cells called prostate-specific membrane antigen (PSMA). Once attached, the Pluvicto (lutetium lu 177 vipivotide tetraxetan) enters the cell. Then, the radioactive portion of the medication (lutetium-177) causes radiation damage so that the prostate cancer can’t grow or spread as easily.
Drug Facts
What are the side effects of Pluvicto (lutetium lu 177 vipivotide tetraxetan)?
Common Side Effects
- Feeling very tired (43%)
- Dry mouth and throat (39%)
- Nausea (35%)
- Anemia (32%)
- Poor appetite (21%)
- Constipation (20%)
- Diarrhea (19%)
- Vomiting (19%)
Other Side Effects
- Weight loss
- Fever
- Stomach pain
- Urinary tract infection (UTI)
- Dizziness
- Headache
- Changes in taste
Serious Side Effects
- Low blood cell counts: fever, chills, feeling very tired, unusual bleeding or bruising
- Kidney problems: making little or no urine, dark urine
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Low red blood cell level—unusual weakness or fatigue, dizziness, headache, trouble breathing
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Constipation
- Dry mouth
- Fatigue
- Loss of appetite
- Nausea
Pros and cons of Pluvicto (lutetium lu 177 vipivotide tetraxetan)
Pros
Recommended treatment for metastatic, castration-resistant prostate cancer after other treatments have stopped working
Treatments are given once every 6 weeks
Targeted therapy, so it works in a more specific way than traditional chemotherapy
Cons
Often causes fatigue, nausea, and dry mouth
Need to receive the infusion in a specialized clinic by those trained in giving radiopharmaceuticals
Radioactive treatment, so extra safety precautions are needed after treatment
Pharmacist tips for Pluvicto (lutetium lu 177 vipivotide tetraxetan)
Pluvicto (lutetium lu 177 vipivotide tetraxetan) is a radiation treatment. At the treatment center, you’ll likely be in a separate area to prevent others from radiation exposure. Your treatment team will wear protective equipment and give you instructions on radiation safety after you leave the clinic.
For the first few days after each Pluvicto (lutetium lu 177 vipivotide tetraxetan) dose, you’ll still have radiation in your body that could be harmful to others. Try to stay at least 3 ft away from others for the first 2 days after your Pluvicto (lutetium lu 177 vipivotide tetraxetan) dose, and avoid sexual activity with others for 7 days after the dose.
Radiation can be especially harmful to children and unborn babies. Limit close contact (closer than 3 feet) with children and pregnant women for 7 days after your Pluvicto (lutetium lu 177 vipivotide tetraxetan) dose. You should also sleep in a separate room from children for 7 days, and from pregnant women for 15 days after each treatment.
Drink plenty of water and urinate frequently before and after treatment with Pluvicto (lutetium lu 177 vipivotide tetraxetan). This helps prevent potential kidney damage from the radiation.
Pluvicto (lutetium lu 177 vipivotide tetraxetan) can lower blood cell counts, which can raise your risk for infections and bleeding. Let your provider know if you have signs of unusual bleeding or bruising, or signs of an infection, like weakness, trouble breathing, fever, chills, sore throat, or mouth sores.
Dry mouth is a common side effect of Pluvicto (lutetium lu 177 vipivotide tetraxetan) . If you’re feeling dryness in your mouth or throat, make sure to stay well-hydrated. You can also try over-the-counter saliva substitutes, sugar-free gum, or lozenges to help relieve your symptoms.
Pluvicto (lutetium lu 177 vipivotide tetraxetan) can harm unborn babies and affect fertility. Talk with your provider before starting treatment if you plan on having children. If you have a partner who can become pregnant, continue using effective birth control while on treatment and for 14 weeks after your last dose.
Frequently asked questions about Pluvicto (lutetium lu 177 vipivotide tetraxetan)
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What are the risks and warnings for Pluvicto (lutetium lu 177 vipivotide tetraxetan)?
Pluvicto (lutetium lu 177 vipivotide tetraxetan) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Radiation exposure
Since Pluvicto (lutetium lu 177 vipivotide tetraxetan) is a radiation-based treatment, it can add to your overall radiation exposure over time. And higher total amounts of radiation exposure can raise risk for cancer. Talk with your provider if you’re concerned about radiation exposure, and precautions you can take to protect yourself and others during Pluvicto (lutetium lu 177 vipivotide tetraxetan) treatment.
Low blood cell counts (bone marrow suppression)
Pluvicto (lutetium lu 177 vipivotide tetraxetan) affects your bone marrow and causes your body to make fewer blood cells. Low amounts of blood cells can raise your chance of bleeding and make you more likely to get infections. Your provider will monitor your blood work before each treatment to make sure that your blood cell levels are safe. And if needed, they might make changes to your dosing schedule or dose of Pluvicto (lutetium lu 177 vipivotide tetraxetan). Talk to your healthcare provider right away if you suddenly have unusual bleeding or bruising, muscle weakness, changes in your speech and vision, or develop a fever.
Kidney problems
Risk factors: History of kidney problems
Pluvicto (lutetium lu 177 vipivotide tetraxetan) can harm the kidneys, especially if you’ve had previous kidney problems. Your treatment team will do a blood test to check that your kidneys are healthy before each treatment. It’s a good idea to stay well-hydrated and urinate frequently before and after treatment to keep your kidneys working well. Let your provider know if you have little or no urine. That could be a sign of kidney problems, and you might have to temporarily delay treatment while your kidneys recover.
Harm to the unborn baby
Pluvicto (lutetium lu 177 vipivotide tetraxetan) can harm unborn babies. If you have a partner who’s able to become pregnant, continue using effective birth control while taking Pluvicto (lutetium lu 177 vipivotide tetraxetan) and for at least 14 weeks after the last dose.
Fertility problems
Pluvicto (lutetium lu 177 vipivotide tetraxetan) can lead to infertility. Before starting treatment, talk with your provider if you are planning on having children.
Pluvicto (lutetium lu 177 vipivotide tetraxetan) dosage forms
Typical dosing for Pluvicto (lutetium lu 177 vipivotide tetraxetan)
The typical dose is 7.4 GBq as an injection through the vein about every 6 weeks for up to 6 doses.
Your dose might be different if you develop certain side effects to the medication.
Note: GBq is a unit of radioactivity. Since this medication works by delivering radiation, the dose is described using units that measure radioactivity.
What are alternatives to Pluvicto (lutetium lu 177 vipivotide tetraxetan)?
Metastatic castration-resistant prostate cancer that’s positive for PSMA, after using androgen receptor pathway blocker and taxane chemotherapy treatments
Prostate cancer that has spread to other areas of the body (used in combination with prednisone)
Pluvicto (lutetium lu 177 vipivotide tetraxetan) images
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References
Best studies we foundAdvanced Accelerator Applications USA, Inc. (2024). Pluvicto- lutetium lu 177 vipivotide textrazetan injection, solution [package insert]. DailyMed.
American Cancer Society. (2019). Radiation therapy safety.
American Cancer Society. (2023). Radiation therapy for prostate cancer.
Chang, S. S. (2004). Overview of prostate-specific membrane antigen. Reviews in Urology.
Kratochwil, C., et al. (2023). Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT). European Journal of Nuclear Medicine and Molecular Imaging.
Munjal, A., et al. (2023). Radiopharmaceuticals. StatPearls.
National Comprehensive Cancer Network. (2023). Advanced-state prostate cancer.
Novartis Pharmaceuticals Corporation. (2024). What to expect when taking Pluvicto.
Prostate Cancer Foundation. (n.d.). Chemotherapy for prostate cancer.
Sartor, O., et al. (2021). Lutetium-177–PSMA-617 for metastatic castration-resistant prostate cancer. The New England Journal of Medicine.
United States Nuclear Regulatory Commission. (2021). Becquerel (Bq).
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