Lutetium Lu 177 Vipivotide Tetraxetan
Also known as: Pluvicto, 177Lu-PSMA-617, Lu-PSMA-617
A PSMA-targeted radioligand that delivers radiation to prostate cancer cells, FDA-approved in 2022 as Pluvicto. Prescription drug.
Last updated
Mechanism of Action
Lutetium Lu 177 vipivotide tetraxetan (177Lu-PSMA-617) is a small peptidomimetic molecule that binds prostate-specific membrane antigen (PSMA), a protein highly expressed on most prostate cancer cells, linked to a DOTA chelator holding lutetium-177. After binding PSMA it is internalized, and lutetium-177 emits beta particles that damage DNA in the tumor and surrounding cells over a few millimeters. Salivary and lacrimal glands and kidneys also take it up, which explains dry mouth and kidney monitoring.
- Half-life
- ~6.6 days (physical half-life of lutetium-177)
- Administration Routes
- Intravenous
- Research Status
- Clinical
Reported Benefits
- Improved overall and radiographic progression-free survival in PSMA-positive metastatic castration-resistant prostate cancer after hormonal therapy and chemotherapy (VISION)
- Prolonged radiographic progression-free survival before chemotherapy versus switching hormonal therapy (PSMAfore)
- Prolonged radiographic progression-free survival when added to hormonal therapy in metastatic hormone-sensitive disease (PSMAddition)
Potential Side Effects
- Fatigue
- Dry mouth
- Nausea, decreased appetite and constipation
- Bone marrow suppression (anemia, low platelets and white cells)
- Kidney toxicity and possible infertility
Common Dosing
Given as intravenous injections by nuclear medicine teams, typically every 6 weeks for up to six doses, with activity measured in GBq/mCi and blood counts and kidney function checked before each dose. Patients are selected by a PSMA PET scan showing PSMA-positive disease. Dosing is set and supervised by the prescribing clinician.
The dosing information above is aggregated from research literature and anecdotal community reports for educational purposes only. It is not a recommendation, prescription, or medical advice. Peptides are sold as research chemicals only and are not intended for human use.
Contraindications
- No absolute contraindications on the US label
- PSMA-negative disease is not expected to respond
- Can cause fetal harm and infertility; contraception and radiation precautions are required
No documented stacking partners for Lutetium Lu 177 Vipivotide Tetraxetan yet.
- View
Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer
2021
- View
(177)Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor therapy for taxane-naive patients with progressive metastatic castration-resistant prostate cancer (PSMAfore): a phase 3, randomised, controlled trial
2024
- View
[(177)Lu]Lu-PSMA-617 in patients with PSMA-positive metastatic androgen pathway modulator-naive/sensitive prostate cancer (PSMAddition): a phase 3 randomised, controlled trial
2026
- View
[(177)Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial
2021