Methods for Preparation and Administration of Pluvicto™ (177Lu-PSMA-617) - Kendra Harris
May 10, 2022
Kendra Harris, MD, MSc, Chair, Radiation Oncology, Associate Professor, Tulane Cancer Center, Tulane University School of Medicine
Administering Pluvicto™ and Patient Feedback on His Final Dose of 177Lu-PSMA-617- Kendra Harris and Phillip Koo
Preparing Your Patient for a 177Lu-PSMA-617 Dose - Kendra Harris
Pluvicto™ (177Lu-PSMA-617) Indications for Clinical Use in PSMA Positive Metastatic Castration-Resistant Prostate Cancer mCRPC - Oliver Sartor
Kendra Harris: Left hand. Right hand. Okay. So now we go ahead and head into the hot lab, which for us is quite compact. My physicist has already received the dose, filled out the Department of Transportation log, has done the calibration necessary, and verified the receipt of the release information from the company. I'm going to go ahead now and pull this up in anticipation of the patient's coming IV injection. Of course, I'm wearing all of the appropriate safety equipment. We're trying to use and follow the principles of minimum exposure while also following sterile technique. So, first I prepare the large syringe that will pull the dose up and the spinal needle that's required because of the glass vial height. I will vent the vial using a smaller needle that has a filtered vent affixed to the top.
So as soon as I've got my needles and vent prepped, I go ahead and open up the lead pig using tongs. I then sterilize the top of the pig. I affix the spinal needle to the syringe and discard the sheath, piercing the top. I take my vented spinal needle and do the same. And then I pull the dose up slowly with the vial inside the pig. At the end, I have to take it out just to get the last of the dose pulled up. And once the dose is pulled up, I can then put the cap on here and place it inside my calibrator. This allows me to check the dose. Here we have 194.7 millicuries, and I need to get my physicist to do a double check.
All right. So once I have verified the dose, I then have the patient label, which is the dose, the agent we're going to infuse, when it was prepared, who it was prepared by, and the expiration date, which we have from the release from the company. I go ahead and place this on the syringe. I'm trying to hide this patient's name. And then we put the syringe into a beta shield, the beta shield into a lead igloo for transport, and we're ready to go.