Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Apr;28(2):247-252.
doi: 10.1111/hdi.13144. Epub 2024 Mar 6.

Dosing lutetium Lu 177-dotatate for a hemodialysis patient

Lindsay Taylor  1 , Richard Meades  2 , Ann-Marie Quigley  2 , Christos Toumpanakis  3 , Catriona Goodlad  1 , Andrew Davenport  1
Affiliations
Case Reports

Dosing lutetium Lu 177-dotatate for a hemodialysis patient

Lindsay Taylor et al. Hemodial Int. 2024 Apr.

Abstract

Lu177-dotatate (Lutathera™) is a radioactive drug approved for the treatment of adults with gastro-entero-pancreatic neuroendocrine tumors and is predominantly renally excreted. Currently all patients receive 7400 MBq (200 mCi), and there are no guidelines for treating hemodialysis patients. We measured radioactivity prior to and post administration of two cycles of Lu177-dotatate in a hemodialysis patient, and radiation exposure to staff. We reduced the standard 7400 MBq by 33% for the first cycle and patient radioactivity fell by 40% following postdilution hemodiafiltration started 6 h post dosing, and by 45% for the second cycle and radioactivity fell by 47% with postdilution hemodiafiltration started 5 h post administration. By reducing the initial administered radioactivity, coupled with early dialysis, and choosing postdilution hemodiafiltration we were able to achieve radioactivity retention curves similar to those from patients with normal renal function receiving the standard administration of 7400 MBq.

Keywords: Lutetium Lu 177‐dotatate; hemodiafiltration; hemodialysis; neuroendocrine; somatostatin; tumor.

PubMed Disclaimer

References

REFERENCES

    1. Das S, Al‐Toubah T, El‐Haddad G, Strosberg J. 177Lu‐DOTATATE for the treatment of gastroenteropancreatic neuroendocrine tumors. Expert Rev Gastroenterol Hepatol. 2019;13(11):1023–1031.
    1. Strosberg JR, Caplin ME, Kunz PL, Ruszniewski PB, Bodei L, Hendifar A, et al. 177Lu‐Dotatate plus long‐acting octreotide versus high‐dose long‐acting octreotide in patients with midgut neuroendocrine tumours (NETTER‐1): final overall survival and long‐term safety results from an open‐label, randomised, controlled, phase 3 trial. Lancet Oncol. 2021;22(12):1752–1763.
    1. Jia AY, Kashani R, Zaorsky NG, Spratt DE, Kiess AP, Michalski JM, et al. Lutetium‐177 DOTATATE: a practical review. Pract Radiat Oncol. 2022;12(4):305–311.
    1. Strosberg J, El‐Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, et al. NETTER‐1 trial investigators. Phase 3 trial of 177Lu‐Dotatate for midgut neuroendocrine tumors. N Engl J Med. 2017;376(2):125–135.
    1. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173(5):489–495.

Publication types

LinkOut - more resources