From the FDA Drug Label
LUTATHERA is indicated for the treatment of adult and pediatric patients 12 years and older with somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors. The recommended LUTATHERA dosage for adult and pediatric patients 12 years and older is 7.4 GBq (200 mCi) every 8 weeks (± 1 week) for a total of 4 doses.
The treatment options for Lutathera (Lutetium Dotatate) include:
- Somatostatin Analogs: Discontinue long-acting somatostatin analogs at least 4 weeks prior to initiating LUTATHERA, and administer short-acting octreotide as needed.
- Antiemetics: Administer antiemetics before the recommended amino acid solution.
- Amino Acid Solution: Initiate an intravenous infusion of a sterile amino acid solution containing L-lysine and L-arginine 30 minutes before the start of the LUTATHERA infusion.
- Hypersensitivity Prophylaxis: Premedicate patients who have had prior Grade 1 or 2 hypersensitivity reactions to LUTATHERA.
- Dosage Modifications: Recommended dose modifications of LUTATHERA for adverse reactions are provided in Table 2, including withholding or permanently discontinuing LUTATHERA for certain adverse reactions 1.
From the Research
Introduction to Lutathera (Lutetium Dotatate) Treatment
Lutathera, also known as Lutetium Dotatate, is a radiopharmaceutical used for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that are somatostatin receptor-positive. The treatment involves the administration of Lutetium-177, a radioactive isotope, attached to a somatostatin analog, which binds to somatostatin receptors overexpressed by these tumors.
Treatment Options and Administration
The treatment options for Lutathera include:
- Administration of Lutetium-177 Dotatate as a single agent for the treatment of GEP-NETs
- Combination therapy with other agents, such as nivolumab, an anti-PD-1 antibody, to generate antitumor immunity 2
- Co-infusion of amino acids to prevent nephrotoxic effects of Lutetium-177 Dotatate 3
Dosage and Administration
The recommended dosage of Lutetium-177 Dotatate is 7.4 GBq, administered every 8 weeks for four doses 2, 4. The treatment can be repeated for a cumulative dose of up to 29.6 GBq.
Treatment Efficacy and Toxicity
The treatment efficacy of Lutetium-177 Dotatate has been shown to be associated with tumor shrinkage and improved survival 5, 4. However, the treatment can also cause toxicity, including lymphopenia, thrombocytopenia, anemia, and nausea 2, 3. The absorbed dose by tumors and healthy organs can predict survival and toxicities, influencing clinical management 5.
Patient Selection and Monitoring
Patient selection for Lutetium-177 Dotatate treatment should be based on the presence of somatostatin receptor-positive GEP-NETs, which are usually inoperable and have progressed despite standard therapy 6. Patients should be monitored regularly for toxicity and response to treatment, including laboratory parameters and imaging studies.
Conclusion
Lutathera (Lutetium Dotatate) is a treatment option for patients with somatostatin receptor-positive GEP-NETs. The treatment involves the administration of Lutetium-177 Dotatate, which can be used as a single agent or in combination with other therapies. Patient selection and monitoring are crucial to ensure safe and effective treatment. The absorbed dose by tumors and healthy organs can predict survival and toxicities, influencing clinical management.