Pluvicto also uses Lu-177 as the radioisotope (which is a beta emitter that decays to Hf-177) but its ligand is a prostate-specific membrane antigen (PSMA) targeted ligand as this radioligand therapy addresses metastatic prostate cancer. It was FDA approved in 2022. The difference between Lutathera and Pluvicto is shown in the chemical linkages in the images above. The production, transportation, and storage is the same as Lutathera. The therapy is administered intravenously through gravity, syringe, or a Peristaltic Infusion Pump. The major warnings include renal toxicity, infertility in males, and embryo/fetal harm. General side effects of this radioligand therapy include fatigue, nausea, dry mouth, anemia, decreased appetite, and constipation. Regular blood tests and imaging post-therapy are needed to see if the radioligand therapy is working and its side effects.
The benefits of Pluvicto include delaying tumor growth, extending life by about 20 months, and destroying tumor cells by damaging the DNA inside those cells.
Xofigo, a radioligand therapy that was FDA approved in 2013, uses Radium-223 dichloride as the radioisotope, but its ligand varies from Pluvicto. Pluvicto only attacks cancer cells expressing PSMA, but Xofigo attacks all bone metastases. Qualified patients are 30% less likely to die when treated by Xofigo than if treated by a placebo. Ra-223-chloride is an alpha-emitting bone targeting agent.