Pluvicto

Generic name: lutetium Lu 177 vipivotide tetraxetan
Dosage form: injection, for intravenous use
Drug class: Therapeutic radiopharmaceuticals

Medically reviewed by Judith Stewart, BPharm. Last updated on Apr 3, 2024.

What is Pluvicto?

Pluvicto is a targeted radiopharmaceutical treatment for the treatment of adult patients with a certain type of advanced cancer called prostate-specific membrane antigen-positive metastatic castration-resistant prostate cancer (PSMA-positive mCRPC) that has spread to other parts of the body.

Pluvicto is used in patients who have already been treated with other anti-cancer treatments.

Patients will need a scan before receiving Pluvicto, using Locametz or another approved PSMA-11 imaging agent to identify the PSMA-positive lesions.

Warnings

Pluvicto may cause harm to an unborn baby.

Men with female partners should use effective contraception for intercourse during treatment with Pluvicto, and for 14 weeks after the last dose.

Pluvicto may cause temporary or permanent infertility in males.

Pluvicto contributes to your overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk for cancer.

To minimize radiation exposure to others after you receive Pluvicto

you should limit close contact (less than 3 feet) with household contacts for 2 days or with children and pregnant women for 7 days
you should refrain from sexual activity for 7 days
you should sleep in a separate bedroom from household contacts for 3 days, from children for 7 days, and from pregnant women for 15 days.

Pluvicto can cause severe and life-threatening myelosuppression, including anemia, thrombocytopenia, leukopenia, and neutropenia.

Pluvicto can cause severe renal toxicity. You should remain well hydrated and urinate frequently before and after administration of Pluvicto to prevent kidney injury. You will receive kidney function tests before and during your treatment.

Who should not receive Pluvicto?

You should not receive Pluvicto if you are allergic to lutetium Lu 177 vipivotide tetraxetan.

Before you receive Pluvicto

Before you receive Pluvicto, tell your doctor if you:

have low blood cell counts (hemoglobin, white blood cell count, absolute neutrophil count, platelet count)
have signs of myelosuppression (tiredness, weakness, pale skin, shortness of breath, bleeding or bruising more easily than normal or difficulty stopping bleeding, or frequent infections with signs such as fever, chills, sore throat, or mouth ulcers)
have kidney problems
have any other type of cancer or treatment for cancer. Pluvicto contributes to long-term cumulative radiation exposure.
have a female partner who is pregnant or planning to become pregnant. All radiopharmaceuticals, including Pluvicto, have the potential to cause harm to an unborn baby. Patients should use effective contraception for intercourse during treatment with Pluvicto, and for 14 weeks after the last dose. Pluvicto may cause temporary or permanent infertility in males.

How will I receive Pluvicto?

Before you receive Pluvicto, you will receive a scan to identify the tumors that express PSMA.

Pluvicto is a radiopharmaceutical and your healthcare provider will take appropriate safety measures to minimize radiation exposure including the wearing of waterproof gloves and effective radiation shielding.

Pluvicto is administered via intravenous injection every 6 weeks for up to 6 doses, or until disease progression or unacceptable toxicity.

Before administration of Pluvicto patients should drink plenty of water in order to urinate as often as possible during the first hours after administration.

Dosing information

Usual Adult Dosage for Prostate Cancer

- 7.4 GBq (200 mCi) every 6 weeks for up to 6 doses.

- Use: treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor (AR) pathway inhibition and taxane-based chemotherapy.

Pluvicto side effects

Pluvicto may cause serious side effects including:

Myelosuppression. Contact your healthcare provider if you experience any signs or symptoms of myelosuppression, such as tiredness, weakness, pale skin, shortness of breath, bleeding or bruising more easily than normal or difficulty to stop bleeding, or frequent infections with signs, such as fever, chills, sore throat or mouth ulcers.
Renal Toxicity. Contact your healthcare provider if you experience any signs or symptoms of renal toxicity such as passing urine less often than usual or passing much smaller amounts of urine than usual.

Common side effects may include:

fatigue
dry mouth
nausea
anemia
decreased appetite
constipation.

What other drugs will affect Pluvicto?

Pluvicto is not thought to interact with other medicines.

Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.