Can Lzu-177 (unknown generic name) infusions cause hair loss?

Lutetium-177 (Lu-177) and Hair Loss in Cancer Treatment

Lutetium-177 (Lu-177) infusions are unlikely to cause significant hair loss as this is not a commonly reported side effect of peptide receptor radionuclide therapy (PRRNT). Unlike conventional chemotherapy agents, Lu-177 therapy typically does not cause the diffuse alopecia that patients often fear with cancer treatment.

Understanding Lu-177 Therapy and Hair Loss Risk

Lu-177 is a radiopharmaceutical used in peptide receptor radionuclide therapy (PRRNT), primarily for neuroendocrine tumors. The treatment works by delivering targeted radiation to tumor cells expressing somatostatin receptors, minimizing exposure to healthy tissues.

Key points about Lu-177 and hair loss:

• Unlike conventional chemotherapy agents that commonly cause hair loss (such as taxanes, anthracyclines, and cyclophosphamide), Lu-177 therapy is not associated with significant alopecia 1
• The European Association of Nuclear Medicine (EANM) guidelines for PRRNT do not list hair loss among the reported side effects of Lu-177 therapy 1
• The most common side effects of Lu-177 therapy include:
  • Nausea/vomiting (usually mild)
  • Fatigue
  • Potential impact on kidney function
  • Potential impact on bone marrow function

Comparison with Known Hair Loss-Inducing Treatments

Hair loss from cancer treatments typically occurs through two main mechanisms:

1. Anagen effluvium: Abrupt cessation of mitotic activity in rapidly dividing hair matrix cells, causing hair loss within days to weeks of drug administration (common with cytotoxic chemotherapy) 2

2. Telogen effluvium: Precipitation of hair follicles into premature rest phase, with hair loss becoming evident 2-4 months after starting treatment 2

Chemotherapy-induced alopecia (CIA) occurs in approximately 48% of patients receiving conventional chemotherapy, with high risk associated with docetaxel, doxorubicin, and cyclophosphamide 3, 4. In contrast, Lu-177 therapy is not mentioned in any guidelines or research as a cause of significant hair loss.

Patient Education and Monitoring

While significant hair loss is not expected with Lu-177 therapy, patients should be monitored for:

• Any unexpected hair thinning (which would be unusual and might suggest another cause)
• Other more common side effects of Lu-177 therapy, including fatigue, nausea, and potential impacts on kidney and bone marrow function 1

Important Considerations

• If a patient experiences unexpected hair loss during Lu-177 treatment, consider other potential causes:

  • Concurrent medications
  • Underlying medical conditions (thyroid disorders, nutritional deficiencies)
  • Stress-related telogen effluvium
  • Age-related hair thinning

• Patients with neuroendocrine tumors receiving Lu-177 therapy should be reassured that significant hair loss is not an expected side effect of this treatment, unlike with many conventional chemotherapy regimens 3, 4

In summary, patients receiving Lu-177 infusions can generally be reassured that significant hair loss is not an expected side effect of this targeted radiopharmaceutical therapy, which represents an advantage over many conventional chemotherapy regimens.