A Case of ¹⁷⁷Lu-DOTATATE Therapy Without the Use of Antiemetics

Recommended ¹⁷⁷Lu-DOTATATE treatment regimens involve prophylaxis with antiemetics to counteract the emetogenic properties of the nephroprotective amino acid solution infusion. We describe a 58-y-old woman treated with ¹⁷⁷Lu-DOTATATE for metastatic small-bowel carcinoid, who was allergic to many classes of antiemetics. Therefore, she was treated with ¹⁷⁷Lu-DOTATATE without antiemetic prophylaxis. She tolerated the compounded amino acid infusion of lysine and arginine, followed by ¹⁷⁷Lu-DOTATATE, without significant nausea or any vomiting. We hypothesize that aggressive antiemetic prophylaxis may not be necessary if a ¹⁷⁷Lu-DOTATATE patient receives compounded lysine/arginine amino acid solutions. The omission would decrease overall health-care costs and limit possible medication side effects.