Abstract | BACKGROUND AND OBJECTIVE: METHODS: 7.4 GBq of 177Lu-Dotatate was administered to 42 patients over a 30-min intravenous infusion. Infusion of AA started 2 h before and continued for 6 h after the infusion of 177Lu-Dotatate. Radioactivity-time data (n = 346) were analyzed using NONMEM® (version 7.2.0). RESULTS:
177Lu-Dotatate pharmacokinetics was best described by a three-compartment model with first-order elimination. AA co-infusion had a significant effect ('fixed effect') on 177Lu-Dotatate pharmacokinetics, with a mean value of 1.5-fold (95% confidence interval 1.03-1.97) increase in the elimination rate constant (k10) from 0.204 to 0.306 h-1, but this AA co-infusion effect was associated with a large inter-individual variability (IIV) of 104%. The individual k10 values increased during concomitant AA infusion by a factor ranging from 1.01 to 21.3 for 27 patients, whereas the opposite effect was observed in 15 patients (range 0.36-0.99) of whom seven had a k10 value lower than 0.85. This variability in AA effect contributed to the variability in 177Lu-Dotatate plasma exposure (area under the concentration-time curve from time zero to Day 15 for C1 [AUCDay15]) that correlated with lymphopenia observed at Day 15 (p = 0.004). CONCLUSIONS: A substantial effect of AA co-infusion on 177Lu-Dotatate pharmacokinetics was shown but was associated with high IIV, contributing to IIV in hematological toxicity.
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Authors | Alicja Puszkiel, Mathilde Bauriaud-Mallet, Roxane Bourgeois, Lawrence Dierickx, Frédéric Courbon, Etienne Chatelut |
Journal | Clinical pharmacokinetics
(Clin Pharmacokinet)
Vol. 58
Issue 2
Pg. 213-222
(02 2019)
ISSN: 1179-1926 [Electronic] Switzerland |
PMID | 29736841
(Publication Type: Clinical Trial, Journal Article)
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Chemical References |
- Amino Acids
- Antineoplastic Agents
- Organometallic Compounds
- lutetium Lu 177 dotatate
- Octreotide
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Amino Acids
(administration & dosage)
- Antineoplastic Agents
(adverse effects, blood, pharmacokinetics)
- Female
- Humans
- Infusions, Intravenous
- Intestinal Neoplasms
(metabolism)
- Kidney
(drug effects)
- Lymphocyte Count
- Male
- Middle Aged
- Models, Biological
- Neuroendocrine Tumors
(metabolism)
- Octreotide
(adverse effects, analogs & derivatives, blood, pharmacokinetics)
- Organometallic Compounds
(adverse effects, blood, pharmacokinetics)
- Pancreatic Neoplasms
(metabolism)
- Stomach Neoplasms
(metabolism)
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