Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is a medicine that is used to treat prostate cancer in adults. Pluvicto may be used to treat PSMA-positive prostate cancer that has spread to other parts of your body. The protein, PSMA, stands for prostate-specific membrane antigen, and some prostate cancer cells have PSMA on their surface, which makes it a PSMA-positive cancer. The prostate cancer must also have previously been treated with both a hormone-blocking medicine and a certain type of chemotherapy called a taxane.
How Does Pluvicto Treat Prostate Cancer?
Pluvicto is a targeted radioactive medicine that works by targeting the PSMA protein on prostate cancer cells. The medication attaches to the PSMA protein. This attachment is like a key going into a lock. Once the medicine has attached to the PSMA protein, it delivers radiation to the cell that damages the cell DNA and causes the cell to die. This helps to shrink the tumor and to prevent the tumor and cancer cells from growing and multiplying.
How Is Pluvicto Given?
Doses are given by an intravenous infusion through a blood vessel in your arm. Your health care provider may choose to give the dose by a few different methods that can take up to 30 minutes. Your dose of Pluvicto is measured by radioactive measurements. The dose will be 7.4 gigabecquerels (GBq) or 200 millicurie (mCi) every 6 weeks. If your cancer does not progress (grow or spread) and you do not have severe side effects, you may receive up to six doses of Pluvicto. If you have certain side effects, your health care provider may skip a dose of Pluvicto or stop your doses altogether.
How Well Does Pluvicto Work for Prostate Cancer?
Pluvicto was approved by the FDA based on clinical trials that compared Pluvicto combined with the standard of care vs. the standard of care alone in PSMA-positive prostate cancer. Standard of care means the medicine that would be used at the time the clinical trial was started. In these trials, the standard of care medicine could be chosen by the health care provider. The clinical trial included 831 people who received one of the two treatments. They were followed to see how long it took for their prostate cancer to progress, meaning that the cancer grew or spread. This is called progression-free survival. The median progression-free survival was 8.7 months for Pluvicto compared to 3.4 months for people who had standard of care. This means that half of the patients who received Pluvicto did not have their cancer progress for at least 8.7 months.
This study also looked at median overall survival, which measured how long half of the people in the study who received a certain medicine survived after starting to use the medicine. People who used Pluvicto in the study had a median overall survival of 15.3 months while people who had standard of care had a median overall survival of 11.3 months.
How Will I Know If It Is Working?
Pluvicto will start working as soon as you receive your first dose. Your health care provider will usually do regular blood tests and scans to see how well your body is responding to the treatment. This can start during your first Pluvicto dose or after your doses, depending on what your health care provider thinks is right for you.
The blood tests will monitor your blood counts, such as white blood cells, neutrophils, and platelets, so that your health care provider knows that you can continue to use Pluvicto safely. If you have certain side effects, such as a change in your urine output, your health care provider may order additional tests to make sure it is safe for you to continue to use Pluvicto.
Other tests of your blood may include PSA (prostate-specific antigen), which is often used to monitor prostate cancer and how active it is in your body. If Pluvicto works for you, it usually causes the PSA to go down after you’ve received the medicine.
How Can I Prevent and Manage Side Effects?
Side effects are common with medicines that treat cancer, including Pluvicto. It is important to tell your health care provider about any side effects you have during or after using Pluvicto. They can help to determine if your side effects are serious or provide more information to help you manage the side effects.
Your health care provider will usually instruct you to take certain medicines before or during your Pluvicto infusion to help prevent the most common side effects, nausea and vomiting. It is important to follow their instructions. You can also ask your health care provider what else you can do to prevent or treat common side effects. For example, eating bland foods and having multiple small meals throughout the day instead of three large meals can help to prevent and treat nausea and vomiting.
If you have certain side effects while you use Pluvicto, your health care provider may need to pause your infusions or even stop your infusions altogether. This will depend on the side effect you experience, how severe it is, and what treatment it needs. If your Pluvicto dose needs to be paused, your health care provider may restart the medication once your side effects are treated.
What Are Other Considerations to Be Aware Of?
Pluvicto can harm an unborn baby. Tell your health care provider if you or your partner are planning to become pregnant. It’s also possible for Pluvicto to cause temporary or permanent infertility in men and people assigned male at birth. Talk with your health care provider about the risks to your fertility and any family planning you should do before using Pluvicto. If you have a partner who is able to become pregnant, it is important to use contraception while you are being treated with Pluvicto and for 14 weeks after your last dose.
You should also talk with your health care provider if you live with children or people who are or may become pregnant. This is important because you will need to avoid close contact with children and pregnant people after you use Pluvicto. After you use Pluvicto, the manufacturers of Pluvicto recommend that you avoid being less than 3 feet of children for 2 days and less than 3 feet of pregnant people for 7 days. You should also sleep in a separate bedroom or space from anyone in your house for 3 days, from any children for 7 days, and from pregnant people for 15 days. It is also important to not have any sexual activity with another person for 7 days after using Pluvicto.
Is There Any Cost Assistance Available?
The manufacturer of Pluvicto has a program called Novartis Patient Support that may be able to offer coupons for Pluvicto infusions.
