Pluvicto Dose Modification for Adverse Reactions

FDA Prescribing Information, Table 1 (2022, current label)

Maps adverse reactions during lutetium Lu-177 vipivotide tetraxetan (Pluvicto) therapy to the prescribing-information actions: continue, withhold, reduce the dose once by 20% to 5.9 GBq, or permanently discontinue.

Also searched as: lutetium-177 · vipivotide tetraxetan · PSMA · prostate cancer · mCRPC · lutetium · prostate · radioligand

Myelosuppression (anemia, thrombocytopenia, leukopenia, or neutropenia)

Renal toxicity

Creatinine clearance by Cockcroft-Gault with actual body weight.

Dry mouth

Gastrointestinal toxicity (abdominal pain, constipation, diarrhea, nausea, vomiting)

Fatigue

Electrolyte or metabolic abnormality (Na, K, Ca)

AST/ALT elevation in the absence of liver metastases

Treatment delay due to an adverse reaction has persisted for more than 4 weeks

Information

Incomplete input

Please provide: at least one adverse-reaction category.

How this tool works

Pluvicto is administered at 7.4 GBq (200 mCi) every 6 weeks for up to 6 doses in PSMA-positive metastatic castration-resistant prostate cancer. The label permits the dosing interval to stretch to 10 weeks for toxicity, allows a single 20% dose reduction to 5.9 GBq (160 mCi) without re-escalation, and mandates permanent discontinuation for defined severe or recurrent reactions or any treatment delay beyond 4 weeks. Answer all categories that apply; the strictest applicable action is reported.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

Clinical questions that use this

Vetting guides that reach for this tool.

Prostate cancer — staging and biochemical recurrence

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