The recommended cumulative dose of 44.4 GBq of PLUVICTO results in a radiation-absorbed dose to the testes within the range where PLUVICTO may cause temporary or permanent infertility. Advise male patients with female partners of reproductive potential to use effective contraception during treatment with PLUVICTO and for 14 weeks after the last dose. No animal studies using lutetium Lu 177 vipivotide tetraxetan have been conducted to evaluate its effect on female reproduction and embryo-fetal development however, all radiopharmaceuticals, including PLUVICTO, have the potential to cause fetal harm. Based on its mechanism of action, PLUVICTO can cause fetal harm. The safety and efficacy of PLUVICTO have not been established in females. Withhold, reduce dose, or permanently discontinue PLUVICTO based on severity of renal toxicity. Perform kidney function laboratory tests, including serum creatinine and calculated creatinine clearance ( CrCl), before and during treatment. In the VISION study, grade 3 or 4 acute kidney injury (3%) and increased creatinine (0.9%) occurred in patients treated with PLUVICTO.Īdvise patients to remain well hydrated and to urinate frequently before and after administration of PLUVICTO. PLUVICTO can cause severe renal toxicity. Withhold, reduce dose, or permanently discontinue PLUVICTO and clinically treat patients based on severity of myelosuppression. Perform complete blood counts before and during treatment with PLUVICTO. One death due to sepsis and concurrent neutropenia was observed. Two deaths (0.4%) due to intracranial hemorrhage and subdural hematoma in association with thrombocytopenia were observed. Grade ≥3 pancytopenia occurred in 1.1% of patients (including 2 fatal events). In the VISION study, grade 3 or 4 decreased hemoglobin (15%), decreased platelets (9%), decreased leukocytes (7%), and decreased neutrophils (4.5%) occurred in patients treated with PLUVICTO. PLUVICTO can cause severe and life-threatening myelosuppression. To minimize radiation exposure to others, advise patients to limit close contact (less than 3 feet) with household contacts for 2 days or with children and pregnant women for 7 days, to refrain from sexual activity for 7 days, and to sleep in a separate bedroom from household contacts for 3 days, from children for 7 days, or from pregnant women for 15 days. Minimize radiation exposure to patients, medical personnel, and household contacts during and after treatment with PLUVICTO consistent with institutional practices, patient treatment procedures, Nuclear Regulatory Commission patient-release guidance, and instructions to the patient for follow-up radiation protection.Įnsure patients increase oral fluid intake and advise them to void as often as possible to reduce bladder radiation. PLUVICTO contributes to a patient’s long-term cumulative radiation exposure, which is associated with an increased risk for cancer. PLUVICTO™ (lutetium Lu 177 vipivotide tetraxetan) is indicated for the 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.
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