Best Patient Care Practices for Administering PSMA-Targeted Radiopharmaceutical Therapy

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Therapy

Background:

• Management protocols for metastatic castration-resistant prostate cancer (mCRPC) are evolving with new therapies.
• 177Lu vipivotide tetraxetan ([177Lu]Lu-PSMA-617) is a PSMA-targeted radiopharmaceutical approved after the VISION study.
• New therapies necessitate updated guidance on patient management, including adverse event (AE) monitoring and radiation safety.

Purpose of the Study:

• To provide best practice guidance for delivering PSMA-targeted radiopharmaceutical therapy (RPT) in mCRPC.
• To address educational gaps in managing AEs and radiation safety for [177Lu]Lu-PSMA-617.
• To emphasize the importance of patient counseling and multidisciplinary collaboration.

Main Methods:

• Review of published evidence and guidelines on RPT management in prostate cancer.
• Drawing on experience from VISION study investigators.
• Identification of educational needs regarding AEs and radiation safety.

Main Results:

• Education on AEs (e.g., fatigue, dry mouth) and radiation safety is crucial for effective treatment delivery and managing patient expectations.
• [177Lu]Lu-PSMA-617 is generally well tolerated, but may require interventions like dose modification, medications, or transfusions.
• Urinary incontinence presents a challenge for radiation safety, requiring careful management.

Conclusions:

• Optimal patient management for [177Lu]Lu-PSMA-617 relies on comprehensive patient counseling and robust multidisciplinary collaboration between medical oncologists and nuclear medicine teams.
• Adherence to radiation safety protocols and continuous monitoring are essential for safe and efficient patient care.
• Individualized benefit-to-risk assessment is critical for each patient receiving PSMA-targeted RPT.