One decade of 'Bench-to-Bedside' peptide receptor radionuclide therapy with indigenous [177Lu]Lu-DOTATATE obtained through 'Direct' neutron activation route: lessons learnt including practice evolution in an Indian setting

Sandip Basu; Sudipta Chakraborty; Rahul V Parghane; Kamaldeep; Rohit Ranade; Pradeep Thapa; Ramesh V Asopa; Geeta Sonawane; Swapna Nabar; Hemant Shimpi; Ashok Chandak; K V Vimalnath; Vikas Ostwal; Anant Ramaswamy; Manish Bhandare; Vikram Chaudhari; Shailesh V Shrikhande; Bhawna Sirohi; Ashutosh Dash; Sharmila Banerjee

One decade of 'Bench-to-Bedside' peptide receptor radionuclide therapy with indigenous [¹⁷⁷Lu]Lu-DOTATATE obtained through 'Direct' neutron activation route: lessons learnt including practice evolution in an Indian setting

Am J Nucl Med Mol Imaging. 2020 Aug 25;10(4):178-211. eCollection 2020.

Authors

Sandip Basu^{1

2}, Sudipta Chakraborty^{2

3}, Rahul V Parghane^{1

2}, Kamaldeep^{2

4}, Rohit Ranade^{1

2}, Pradeep Thapa^{1

2}, Ramesh V Asopa^{1

2}, Geeta Sonawane^{1

2}, Swapna Nabar^{1

2}, Hemant Shimpi^{1

2}, Ashok Chandak^{1

2}, K V Vimalnath³, Vikas Ostwal^{2

5}, Anant Ramaswamy^{2

5}, Manish Bhandare^{2

6}, Vikram Chaudhari^{2

6}, Shailesh V Shrikhande^{2

6}, Bhawna Sirohi^{5

7}, Ashutosh Dash^{2

3}, Sharmila Banerjee^{1

2}

Affiliations

¹ Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe Parel, Mumbai, India.
² Homi Bhabha National Institute Mumbai, India.
³ Radiopharmaceuticals Division, BARC Mumbai, India.
⁴ Health Physics Division, Bhabha Atomic Research Centre Mumbai, India.
⁵ Department of Medical Oncology, Tata Memorial Centre Mumbai, Maharashtra, India.
⁶ Department of Surgical Oncology, Gastrointestinal and Hepato-Pancreato-Biliary Service, Tata Memorial Hospital Mumbai, India.
⁷ Apollo Proton Cancer Centre Chennai, India.

PMID: 32929396
PMCID: PMC7486551

Abstract

The present treatise chronicles one decade of experience pertaining to clinical PRRT services in a large-volume tertiary cancer care centre in India delivering over 4,000 therapies, an exemplar of successful PRRT programme employing indigenous ¹⁷⁷Lutetium production and resources. For the purpose of systematic discussion, we have sub-divided the communication into 3 specific parts: (a) Radiopharmaceutical aspects that describes ¹⁷⁷Lutetium production through 'Direct' Neutron Activation Route and the subsequent radiolabeling procedures, (b) The specific clinical nuances and finer learning points (apart from the routine standard procedure) based upon clinical experience and how it has undergone practice evolution in our setting and (c) Dosimetry results with this indigenous product and radiation safety/health physics aspects involved in PRRT services. Initiated in 2010 at our centre, the PRRT programme is a perfect example of affordable quality health care delivery, with indigenous production of the radionuclide (¹⁷⁷Lu) in the reactor and subsequent radiolabeling of the radiopharmaceutical ([¹⁷⁷Lu]Lu-DOTATATE) at the hospital radiopharmacy unit of the centre, which enabled catering to the needs of a large number of patients of progressive, metastatic and advanced Neuroendocrine Neoplasms (NENs) and related malignancies.

Keywords: 177Lutetium; Direct’ neutron activation route; Neuroendocrine neoplasms (NENs); [177Lu]Lu-DOTATATE; [90Y]Y-DOTATATE; chemo-PRRT; duo-PRRT; neuroendocrine tumor; peptide receptor radionuclide (PRRT); somatostatin receptor (SSTR).

Publication types

Review