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Pretargeted Radioimmunotherapy Based on the Inverse Electron Demand Diels-Alder Reaction

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Lutetium-177 Radiopharmeceutical Therapy Extravasation Lessons Learned.

Kendall Berry¹, Jessica Kendrick

¹Fox Chase Cancer Center, 333 Cottman Avenue, R347, Philadelphia, PA 19111 Kendall.Berry@FCCC.edu.

|March 23, 2022

Summary

A single phone call revealed unpreparedness for Lutetium-177 (177Lu) dotatate extravasations. This paper details lessons learned and plans for early identification of 177Lu extravasations.

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Area of Science:

Nuclear Medicine
Radiopharmaceutical Therapy
Radiation Safety

Background:

Lutetium-177 (177Lu) dotatate has been available since 2017/2018.
The Radiation Safety Department was unprepared for 177Lu extravasations.
Robust infusion centers and nursing expertise were crucial.

Purpose of the Study:

To address the lack of preparedness for 177Lu dotatate extravasations.
To share lessons learned in managing extravasation events.
To outline plans for early identification of 177Lu extravasations.

Main Methods:

A team of radiation safety and diagnostic medical physicists estimated tissue dose.
Research was initiated to identify therapeutic 177Lu extravasations early.
Leveraging infusion center expertise for mitigation efforts.

Main Results:

Extravasation management required collaboration between radiation safety and clinical teams.
Early identification strategies for 177Lu extravasations were developed.
Tissue dose estimation was performed by medical physicists.

Conclusions:

Preparedness for radiopharmaceutical extravasations is critical.
Interdisciplinary collaboration is essential for managing adverse events.
Ongoing research aims to improve early detection of 177Lu dotatate extravasations.