Impact of co-administration of two amino acid solutions on the elimination and adverse effects of 177Lu-Dotatate
population pharmacokinetic analysis
177Lu-Dotatate is a somatostatin analog prescribed to treat neuroendocrine tumours. Plasma concentrations of 177Lu-Dotatate in 83 patients were used to build a population pharmacokinetic model and estimate its pharmacokinetic parameters. Amino acid infusion is associated to decrease the nephrotoxicity of 177Lu-Dotatate. We compared the impact of two amino acid solutions (Primene® which a mixed of 20 amino-acids and Lysakare® composed of only Arginine and Lysine) on pharmacokinetics of 177Lu-Dotatate. Lysakare® does not increase the elimination of 177Lu-Dotatate on average, unlike Primene®. However, for both solutions there is an inter-individual variability in both the impact of the amino acid solution and the elimination of 177Lu-Dotatate. A relationship between 177Lu-Dotatate exposure and treatment-induced lymphopenia was also observed.
The systemic exposure of each patient could be an additional parameter to consider in the individualised management of patients treated with 177Lu-Dotatate. Population pharmacokinetic methodology may lead to a better understanding of both the efficacy and toxicity of this therapeutic modality.
These results open up a new avenue of research and offer the possibility of individually tailoring 177Lu-Dotatate administration for this indication justified by the large pharmacokinetic interindividual variability associated with a limited intrapatient variability of this radiolabeled compound.
Discover the published article
Curr Radiopharm. 2022 Feb 1.doi: 10.2174/1874471015666211228123525. Online ahead of print.
Comparison of Two Types of Amino Acid Solutions on 177Lu-Dotatate Pharmacokinetics and Pharmacodynamics in Patients with Metastatic Gastroenteropancreatic Neuroendocrine Tumors
Marie Lambert, Lawrence Dierickx, Séverine Brillouet, Frédéric Courbon, Etienne Chatelut
Toulouse Cancer Research Center (Oncopole)
Toulouse – FR
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