lutetium (177Lu) vipivotide tetraxetan at a glance
Medicine class
PSMA-targeted therapeutic radiopharmaceutical
How it is given
Into a vein by an authorised nuclear medicine team in a designated clinical setting
Patient selection
PSMA imaging is required to confirm that the cancer is suitable for treatment
After treatment
Hydration, frequent urination and temporary radiation-protection precautions are important
What is lutetium (177Lu) vipivotide tetraxetan used for?
UK-licensed use:
Treatment of adults with PSMA-positive metastatic castration-resistant prostate cancer that has progressed on or after androgen-receptor pathway inhibitor therapy when delaying taxane chemotherapy is considered appropriate.
Treatment of adults with PSMA-positive metastatic castration-resistant prostate cancer previously treated with androgen-receptor pathway inhibition and taxane chemotherapy, or who are medically unsuitable for taxanes.
How does lutetium (177Lu) vipivotide tetraxetan work?
Vipivotide tetraxetan binds strongly to PSMA, a protein commonly expressed by prostate cancer cells. The attached lutetium-177 releases short-range beta radiation, damaging DNA in the bound cell and nearby cells and potentially causing their death.
How to take lutetium (177Lu) vipivotide tetraxetan
This treatment is prepared, handled and administered only by appropriately authorised professionals in a controlled nuclear medicine setting.
It is given directly into a vein.
Drink fluids and urinate frequently before and after administration, unless the clinical team advises otherwise.
Follow the centre's written precautions concerning close contact, sleeping arrangements, sexual activity, toilet hygiene, laundry, travel and unexpected hospital attendance.
No routine fasting or medicine preparation is generally required unless the treating team gives different instructions.
lutetium (177Lu) vipivotide tetraxetan side effects
Common or expected effects
- Dry mouth
- Fatigue
- Nausea or vomiting
- Reduced appetite
- Constipation or diarrhoea
- Anaemia and other reduced blood-cell counts
- Urinary tract infection
- Abdominal discomfort
- Weight loss
- Swelling of the hands, ankles or feet
Get urgent medical advice
- Fever, sore throat or mouth ulcers suggesting infection from reduced white blood cells
- Unusual bruising, bleeding or difficulty stopping bleeding
- Marked tiredness, pallor or breathlessness suggesting anaemia
- A major reduction in urination suggesting acute kidney injury
- Combined anaemia, infection and bleeding symptoms suggesting severe bone-marrow suppression
lutetium (177Lu) vipivotide tetraxetan in pregnancy
This treatment is licensed for prostate cancer and its safety and efficacy have not been established in females. Ionising radiation can harm an unborn baby. Male patients should not father a child and should use condoms during treatment and for 14 weeks after their final administration; specialist advice is needed if pregnancy exposure is possible.
lutetium (177Lu) vipivotide tetraxetan while breastfeeding
The treatment is not indicated in females, and there are no data on transfer into human milk or effects on a breastfed infant or milk production. Any proposed exposure while breastfeeding requires specialist nuclear medicine assessment because the product emits ionising radiation.
lutetium (177Lu) vipivotide tetraxetan interactions
No clinical medicine-interaction studies were required, and no specific interacting medicines are identified in the UK product information. The nuclear medicine team should nevertheless review all prescribed, non-prescribed and complementary products, particularly alongside other cancer treatments.
Common questions about lutetium (177Lu) vipivotide tetraxetan
Answers are fully visible for fast scanning and source review.
What cancer is lutetium (177Lu) vipivotide tetraxetan used to treat?
It is licensed for selected adults with PSMA-positive metastatic castration-resistant prostate cancer after defined previous treatment or when taxane chemotherapy is medically unsuitable.
Why is a PSMA scan needed before lutetium (177Lu) vipivotide tetraxetan?
The scan checks whether cancer sites express enough PSMA for the radioligand to target them.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.