Safety and Therapeutic Optimization of Lutetium-177 Based Radiopharmaceuticals

Peptide receptor radionuclide therapy (PRRT) using Lutetium-177 (Lu-177) based radiopharmaceuticals has emerged as a therapeutic area in the field of nuclear medicine and oncology, allowing for personalized medicine. Since the first market authorization in 2018 of [Lu-177]Lu-DOTATATE (Lutathera (R)) targeting somatostatin receptor type 2 in the treatment of gastroenteropancreatic neuroendocrine tumors, intensive research has led to transfer innovative Lu-177 containing pharmaceuticals to the clinic. Recently, a second market authorization in the field was obtained for [Lu-177]Lu-PSMA-617 (Pluvicto (R)) in the treatment of prostate cancer. The efficacy of Lu-177 radiopharmaceuticals are now quite well-reported and data on the safety and management of patients are needed. This review will focus on several clinically tested and reported tailored approaches to enhance the risk-benefit trade-off of radioligand therapy. The aim is to help clinicians and nuclear medicine staff set up safe and optimized procedures using the approved Lu-177 based radiopharmaceuticals.

Automated summary

Peptide receptor radionuclide therapy (PRRT) using Lutetium-177 (Lu-177) based radiopharmaceuticals has become a personalized treatment approach in nuclear medicine and oncology. The efficacy of Lu-177 radiopharmaceuticals has been well-reported, but data on patient safety and management are needed. This review focuses on tailored approaches to optimize the risk-benefit trade-off of radioligand therapy using approved Lu-177 based radiopharmaceuticals.