Pluvicto™Treatment Information for patients
What is Pluvicto™?
Pluvicto™ is a medicine used to treat adults with a certain type of prostate cancer
The chemical drug name for Pluvicto™ is Lutetium Lu 177 Vipivotide Tetraxetan.
Pluvicto™ is specially designed to deliver radiation treatment directly to prostate cancer cells
Pluvicto™ targets only prostate cancer cells that have a marker, called PSMA, on the cell surface.
Pluvicto™ attaches to the marker, and is absorbed by the cell
When Pluvicto™ is absorbed, it releases radiation that can damage and kill the PSMA+ cell and other cancer cells in the area
You will have a special PET scan to determine PSMA activity in your prostate cancer cells, and see if you are eligible for Pluvicto™ treatment
Because Pluvicto™ treatment uses radiation, you will receive treatment in a private room or semiprivate room. This is to ensure radiation safety procedures are followed. A team of specially trained doctors, nurses, and pharmacists will care for you. The team will also include a Nuclear Medicine clinician and a Radiation Safety Officer who will assist with the infusion You must also follow radiation safety precautions at home after your treatment, to protect your family and loved ones. We will provide you with specific detailed instructions.
The
Pluvicto™
Regimen
Pluvicto™ is given up to a maximum of 6 infusions, with at least 6 weeks between infusions
The treatment takes about 1 hour
You will have blood tests 7-14 days before you begin treatment with Pluvicto™
After your first treatment and between cycles, you will have blood work scheduled every two weeks, and prior to your next dose of Pluvicto™
You will have a scheduled appointment with your oncology provider before each treatment
Pre-treatment preparation
Before treatment, we will review your blood work and check that your liver function, kidney function, and blood counts are acceptable and safe for treatment. You should drink plenty of water to hydrate your body and be able to urinate as soon as possible after your treatment. This helps to clear the radiation from your system and reduce bladder irritation.
The day of therapy
Your treatment room will be specially prepared with drapes to cover and shield appropriate areas of the room and bathroom.
Your family member/friend/caregiver may accompany you on the day of your infusion and wait in the reception area. However, no visitors will be allowed in the treatment area. Visitors under the age of 12 years are restricted in our infusion centers.
The infusion
Your nurse will place an IV line in your arm
You will be given medicine that will help control any nausea or vomiting that you may experience because of the treatment.
The Pluvicto™ infusion will take about 2 minutes. The nurse will administer IV fluids along with the medication to hydrate your kidneys.
You will be asked to urinate right before the start of the infusion, as you cannot get up while the medicationis infusing.
If you experience difficulty with urinary continence, your nurse will discuss options to manage your urine flow.
After the infusion
You will be cleared for discharge once your radiation levels are checked and determined to be safe
Your next Pluvicto™ infusion
Your next dose of Pluvicto might need be adjusted or delayed, depending on side effects. You doctor and healthcare team will decide how many doses and how long between each dose is right for you
Common side effects may include:
Decreased blood counts: Pluvicto™ treatment may cause a drop in your blood cells counts (including white blood cells, red blood cells, and platelets). People with low blood counts can develop serious infections, anemia, or be at risk for bleeding. Your health care provider will routinely check your blood counts.
Call your doctor if you experience: Fever (temperature greater than 100.4 F)
Chills
Dizziness, feeling faint
Shortness of breath
Unusual fatigue
Bruising or bleeding
Fatigue: Fatigue is a feeling of tiredness or exhaustion that may not be relieved by sleep. While it is a common side effect of radiation and chemotherapy, there are several thing you can do to minimize the effect of fatigue on your daily life. These include taking a short walk, resting as needed, avoiding naps too close to bedtime, and eating a balanced diet. However, fatigue may be due to a low red blood count (anemia). If you experience dizziness, feeling faint or shortness of breath, call your doctor right away.
Nausea: You will be given medication in clinic to prevent nausea before each Pluvicto™ infusion. You will also be given a prescription for anti-nausea medication at home. Take as directed.
Dry mouth: To help with dry mouth, try chewing gum or sugar-free hard candies to keep your mouth moist. Continue to drink plenty of water and non-caffeinated beverages. You can use products like artificial saliva and Biotene™ mouthwash. Avoid commercial mouthwashes that contain alcohol.
Decreased appetite: If you do not feel like eating, try eating smaller, frequent meals instead of three large meals. Eat foods and snacks high in protein and calories such as eggs, nuts, yogurt, cheese, pudding, ice cream and nutritional supplements. Please inform us any problems you are having eating and we can arrange a consultation with our dietitians.
Constipation: Pluvicto™ may cause constipation. If you are not able to move your bowels, please discuss with your providers and use only medicines approved by your doctor. Avoid enemas and suppositories while receiving any therapy that can lower your blood counts
Other potential side effects
Radiation exposure: Treatment with Pluvicto™ exposes you to radiation, which can contribute to your long-term radiation exposure. Overall radiation exposure is associated with an increased risk of a second cancer.
Kidney problems: Treatment with Pluvicto™ will expose your kidneys to radiation and may impair their ability to work as normal. Drink plenty of water and urinate often, especially for 2 days after therapy Your doctor will monitor your blood work to assess your kidney function.
Liver problems: Pluvicto™ treatment may also impair liver function, or cause liver injury. Your doctor will monitor your liver using blood tests and may need to adjust or stop your Pluvicto™ treatment accordingly.
Fertility problems: Treatment with Pluvicto™ may cause infertility. This is because your testes absorb radiation over the treatment period. Discuss with your healthcare provider any concerns that you may have regarding your fertility.
Reproductive warning: Pluvicto™ can cause harm to a developing baby. Men with female partners should use effective contraception throughout treatment and up to 4 months afterward, to prevent a pregnancy. Discuss options with your provider.
Radiation Safety Precautions: You must take special precautions to minimize radiation exposure to others after you receive Pluvicto™. You will receive additional information to follow from your healthcare team and separate instructions. See Radiation Safety Precautions handout