Please insert an introduction paragraph about what to expect with the patient information, and the first steps to treatment. Please insert an introduction paragraph about what to expect with the patient information, and the first steps to treatment. Please insert an introduction paragraph about what to expect with the patient information, and the first steps to treatment.
Lutate therapy is a radioactive, intravenous infusion targeting metastasized or inoperable endocrine Gastro-Entero-Pancreatic (GEP) tumours. Most of these tumours express somatostatin receptors in high abundance
Octreotate, the metabolically active element of Lutate, is a somatostatin analogue that is rapidly bound to these receptors, which is labeled with 177- Lutetium is a short-range, beta-radiation emitter, which delivers a therapeutic dose of radiation to the target tumours. The full name is 177Lu-DOTA-Octreotate.
To summarise, lutate therapy delivers targeted radiation therapy to your neuroendocrine tumour cells.
When administering any therapy using radiation there is always a concern for the dose received by non-target tissues and organs. For this particular therapy, the organs that limit the amount of therapeutic radiation that can be delivered are the kidneys and bone marrow
Lutate treatment has demonstrated few adverse effects. However, complications may occur in any invasive procedure. Whilst the likelihood of such events is low, you should be aware that this therapy does carry a small risk of significant harm or even death.
Some side-effects of this therapy may be experienced by some patients. The most frequent sideeffects are fatigue, nausea and vomiting on the day of the infusion. Some hair thinning (not baldness) is sometimes seen. Lost hair re-grows after the therapy is concluded.
Common, less serious bone marrow radiation effects include a temporary reduction in the number of blood cells (red cells, white cells and platelets). Serious, long-term rare effects (~1%) include the development of myelodysplastic syndrome or acute leukemia.
The amount of radiation exposure to your kidneys will be monitored closely. There is a small (~1%) chance of severe irreversible kidney damage as a result of lutate treatment. This is more likely in patients with preexisting renal conditions but cannot always be predicted.
Some patients with functional (hormonally active) neuroendocrine tumours have a small (<1%) risk of stimulating a carcinoid crisis during lutate therapy. This is a serious condition involving the release of highly active hormones and proteins from your tumour, leading to complications such as unstable blood pressure or difficulty breathing. This is treated with short-acting somatostatin analogues and is very manageable once correctly identified.
You may choose to stop the therapy at any point of time. If you develop unexplained signs or symptoms during or after this therapy we ask you to contact your oncologist.
Prior to the therapy you should ensure that you are well-hydrated and there is no need to fast. You will need a blood test prior to starting treatment to ensure your blood counts and kidney function are adequate. You will also be required to have a baseline Ga68 PET scan.
Somatostatin analogue injections (such as sandostatin LAR or lanreotide) should be stopped 4-6 weeks prior to therapy. All other regular medications (including short-acting somatostatin analogues) can be continued.
On the day of your therapy, you will visit the Nuclear Medicine Department. In the Nuclear Medicine Department, our nurse will insert a cannula in your arm.
We will administer the following medications:
• Anti-nausea medication (ondansetron and dexamethasone)
• Amino acid solution (to protect the kidneys and reduce the radiation dose) for 30 minutes
• Lutate infusion (for 30-45 mins)
• Amino acid infusion (for 3.5 hours)
The total treatment will take approximately 4-5 hours.
Once the treatment is completed, you will be scanned in the Nuclear Medicine Department. The imaging will take 30-60 minutes to complete. This scan may be delayed due to the availability of the camera so we ask that you be patient if necessary.
Lutate therapy is delivered in 4 cycles, normally separated by 8 weeks. After each treatment, you will need to visit your oncologist so your progress can be assessed. Consultations with your oncologist, along with blood tests and other investigations, will be scheduled at 2, 4 and possibly 6 weeks after each therapy cycle. Your individual patient schedule will be included in this booklet.
You can bring books, DVDs, crafts and food with you. Portable DVD players can be provided for your entertainment.
If your condition deteriorates following the administration of the Lutate Therapy you may be required to take short acting Octreotide injections.
This may be due to the increasing metabolic activity of your tumour as a result of you being off your somatostatin treatment. You should contact your Oncologist in regards to this management.
