Lutetium Lu 177 vipivotide tetraxetan (Pluvicto) is the only radioligand therapy approved by the U.S. Food and Drug Administration for metastatic prostate cancer, and it’s given through six infusions spaced six weeks apart. The treatment is “actually not that different from many of the infusions patients may have gone through already,” Dr. Sentana Lledo says.
The entire visit may take less than one hour, including the prep work you’ll go through before your infusion. To start, your care team will review your medical history, new or recent symptoms, and current medications. They’ll also take blood samples to check your blood cell counts, kidney function, and overall health. A nurse will measure your vital signs and monitor them throughout the whole process, and you may be given antinausea medication.
Pluvicto is administered through an intravenous infusion, delivering the medicine directly into your bloodstream. A nurse or other healthcare provider will insert an IV line into your arm or connect to a port if you already have one. The infusion itself is brief, typically complete within 10 minutes. “The nurses are going to be very careful in administering it and staying sterile,” Sentana Lledo says. “But you really should not feel anything differently.”
There is also a brief monitoring period before you’re released, says Scott Tagawa, MD, a professor of medicine and urology at Weill Cornell Medicine in New York City. “We make sure there’s no substance reaction, and usually for most centers, we wait until the patient urinates at least once,” he says. This precaution ensures that nobody is near you during what’s called the first void, since the radiation in your urine, while much less than in your body, is not being shielded by your body, he says.
Also for radiation safety, any caregiver you bring with you will likely be asked to remain in a waiting area outside of the room during the infusion. If you ride home with them, or use a taxi or rideshare service, “try to be as far away as possible from the driver,” Sentana Lledo says. “We really discourage patients from using public transportation.”
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