Formulation of patient dose of 177Lu-DOTA-TATE in hospital radiopharmacy in India: Preparation using in situ methodology vis-a-vis freeze-dried kit

摘要

Peptide receptor radionuclide therapy (PRRT) using radio-labeled somatostatin analogs, particularly 177Lu-DOTA-TATE, is now an established therapeutic modality for the treatment of patients suffering from a wide variety of inoperable neuroendocrine tumors. In the past decade, PRRT has gained momentum and at present is being routinely used as a therapeutic regimen in a limited number of countries. In India, PRRT employing 177Lu-DOTA-TATE has been in regular use since 2008, and to date, more than 1000 patient doses have been administered in 10 nuclear medicine centers across the country. India, with a large population, has a significant number of patients who require PRRT, and need to be provided at a reasonable cost due to the poor affordability in a large part of the population. This demands the formulation of the agent using 177Lu obtained through the more economical and indigenously produced direct (n,gamma) route using enriched 176Lu as a target.