Background Treatment with Lutetium177 is having a highly efficient therapeutic approach for the systemic treatment of various types of cancer including neuroendocrine tumours. However, renal and haematopoietic toxicities are the major limitations of this therapeutic approach.
Purpose To evaluate the use of an arginine and lysine amino-acid solution as a magistral formula to prevent nephrotoxicity in patients treated with the Lutetium-Octreotate radioactive isotope.
Material and methods A retrospective observational study of patients treated with this solution was made.
For this purpose, the so-called 2.5% arginine/lysine 2.5% solution is prepared, which must be administered intravenously as a premedication of each cycle of Lutetium therapy. For the preparation of 1000 ml of solution, 25 g of arginine hydrochloride and 25 g of lysine hydrochloride were weighed and dissolved in 1000 ml of water for injection. The most aseptic conditions in the horizontal laminar flow cabinet (CFLH) should be used. The resulting solution was stored in a refrigerator and assigned a shelf life of 48 hours. The amino-acid solution is pre-administered to radioisotope therapy.
Results The results found were the following:
Conclusion The administration of this solution was able to maintain renal function at normal values and thus avoid the toxicity produced by Lutetium-Octreotate.
The absence of nephrotoxicity and the good tolerance to the amino-acid solution of arginine and lysine imply an effectiveness and safety in the treatment with Lutetium-Octreotate 177. In spite of limited experience, it is possible to recommend the use of the lysine and arginine amino-acid solution to prevent nephrotoxicity in cancer patients undergoing this therapy.
References and/or Acknowledgements I would like to express my special thanks to Ramón Gómez, pharmacist at Hospital Quirón of Torrevieja, who provided the composition of this formula.
No conflict of interest
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