Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is an advanced, FDA-approved radioligand therapy used to treat adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC). This precision treatment delivers targeted radiation directly to advanced prostate cancer cells that have spread to other parts of the body, sparing most healthy surrounding tissue.
Why It Is Used
- Targeted Oncology: Specifically designed for advanced prostate cancer that is no longer responding to standard hormone therapy lowering testosterone.
- Proven Indications: Indicated for patients who have already undergone androgen receptor pathway inhibitor (ARPI) therapy, and who have either previously received taxane-based chemotherapy or are appropriate candidates to delay it.
- Theranostic Companion: Targets the specific PSMA protein biomarker found abundantly on the surface of most prostate cancer cells.
How It Works
- Homing Mechanism: The medication features a targeting molecule that acts like a GPS, traveling through the bloodstream to bind tightly onto cells expressing the PSMA protein.
- Cellular Destruction: Once attached to the tumor, Pluvicto delivers a powerful, localized dose of therapeutic radiation (Lutetium-177) directly into the cancer cell to damage its DNA and destroy it.
The Treatment Process
- Pre-Treatment Evaluation: Patients must first undergo a diagnostic PSMA PET/CT scan (such as Locametz or Posluma) to visually confirm that their tumors express the necessary PSMA targets.
- Dosing Schedule: Administered by an intravenous (IV) infusion lasting just a few minutes. The full regimen typically consists of up to 6 doses given every 6 weeks.
- Continuous Monitoring: Routine blood tests are performed throughout the course of care to track blood counts, kidney function, and liver health.
Safety and Post-Treatment Precautions
- Temporary Radioactivity: Because Pluvicto is a radioactive therapy, patients temporarily emit low levels of radiation from their bodies and fluids for a few days following each injection.
- Post-Dose Guidelines: Patients must follow strict radiation safety practices, which include drinking plenty of fluids to flush the medication out through urine, avoiding sexual activity for 7 days, sleeping in a separate bed for 3 to 7 days, and maintaining a safe distance (at least 3 feet) from family members and pets.