Radioisotope therapy, also known as targeted radionuclide therapy, uses a radioactive drug that seeks out and destroys cancer cells while minimizing damage to neighboring healthy cells.
Lutathera® is a radioisotope therapy that is targeted for cancers affecting the neuroendocrine cells of the pancreas and gastrointestinal tract. The FDA approved Lutathera in January 2018. The University of Kansas Cancer Center is one of the first in the region to offer this advanced treatment.
What is radioisotope therapy?
Radioisotope therapy is a procedure where liquid radiation, such as Lutathera, along with amino acids to protect the kidneys, are administered through an infusion. The liquid radiation targets cancerous cells while causing minimal damage to surrounding healthy cells.
Radioisotope therapy with Lutathera is approved for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). This treatment provides a new option for those who continue to see cancer growing or progressing after initial treatment options.
Who can have radioisotope therapy?
Lutathera is for patients in general good health, with no liver or kidney dysfunction, who have pancreatic or small-bowel tumors that are recurring, inoperable or have not responded to treatment such as:
- Microwave ablation
- Oral chemotherapy
- Long-acting octreotide injections alone
If you are a candidate for surgery, we may offer Lutathera as a first treatment, depending on your condition.
How does radioisotope therapy work?
Cancer treatments involve different strategies and different therapies, such as chemotherapy and radiation. While traditional radiation is the most used radiation treatment option, radioisotope therapy enables treatment to target cancer cells throughout the body. Like chemotherapy, radioisotope therapy involves medication that travels through the bloodstream. The main difference from chemotherapy is this substance targets specific cells, reducing the damage to healthy cells and limiting potential side effects.
Lutathera combines Lutetium 177, a radioactive element, with Dotatate, a type of octreotide, a hormone that inhibits cell growth. This 2-part combination works differently than other cancer treatments. The first part helps find and target cancer cells through the use of somatostatin receptors while the radioactive part kills the cells.
Benefits and risks of radioisotope therapy
Neuroendocrine tumors of the pancreas and small bowel cause exocrine secretions of growth and other hormones and can cause severe diarrhea. This life-threatening cancer can metastasize to organs such as the liver. Radioisotope therapy with Lutathera is able to target and kill these cancer cells.
As with all radiation treatments, there is the risk of possible side effects. We can provide medications to prevent or relieve the most common side effects, which are usually related to the amino acid infusion. These include:
- Muscle ache
- Nausea and vomiting
Throughout your treatment regimen, we provide care to manage any side effects from Lutathera, which can be serious. These may include:
- Decreased blood cell counts
- Increased liver enzymes
- Decreased blood potassium levels
- Increased glucose in your bloodstream
Because Lutathera is a form of nuclear medicine therapy, there are steps you will need to take to reduce radiation exposure to your family, friends and the general public. While receiving your treatment, family members may accompany you but may be asked to leave during the 45-minute Lutathera infusion. You also may be instructed to limit close contact with children and pregnant women for the first 2 weeks after treatment. Drinking plenty of water before, during and after your treatment helps flush the radiation from your body.
What happens during radioisotope therapy?
Before treatment, you will have a diagnostic PET scan to locate the tumor. We will present our findings at a multidisciplinary tumor conference and discuss your condition to determine the course of treatment that best suits your needs.
You’ll have an intravenous liquid infusion of Lutathera and an amino acid that protects your kidneys from radiation. The amino acid infusion begins first, followed by Lutathera shortly after. The Lutathera infusion takes about 45 minutes, and the amino acid infusion takes 4-6 hours.
Drink plenty of water or juice before, during and after your treatment. Because Lutathera is slightly radioactive, the more you urinate the faster you rid your body of radiation. We will let you know when you can leave the cancer center, and we will give you posttreatment instructions at that time.
You will have 4 Lutathera infusion sessions, 1 every 2 months. After each session, you’ll receive an injection of long-acting octreotide. After your last infusion, you’ll receive octreotide injections for up to 18 months, depending on whether the cancer grows or metastasizes.