What is it about?
Lu-177 DOTA-octreotide is a succesful radionuclide therapy to treat neuroendocrine metastasized cancer. Besides the actual therapeutic radionuclide Lu-177 it also may contain the isomer Lu-177m with a 24 fold longer decay half life. This admixture (usually < 0.1% at injection time) has raised concern on possible dosimetric consequences. The absorbed dose to receptor-posistive organs, like pancreas and gallbladder show the highest increase by 1%.
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Why is it important?
The longer-lived isomer may cause an almost continuous exposure to organs trapping the radiopeptide, as it decays to Lu-177 which decays through beta-emission. Trapping will occur in tissues expressing the somatostatin receptor, like the tumour, pancreas and gallbladder. Enhancement of the tumour dose is obviously of no concern and the absorbed dose enhancement in pancreas and gallbladder is too low to reconsider treatment strategy.
Perspectives
This paper is the result of fiddling around with pharmacokinetic modeling, solving differential equations and dose calculations and was performed to address regulatory concerns on the effects by the 160 day half-life Lu-177m.
Dr Mark W Konijnenberg
Erasmus Universiteit Rotterdam
Read the Original
This page is a summary of: Consequences of meta-stable 177mLu admixture in 177Lu for patient dosimetry, Current Radiopharmaceuticals, August 2015, Bentham Science Publishers,
DOI: 10.2174/1874471008666150313121315.
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