[aldoctc]

Quote from stephenhumes

Just wanted to check the pulse out there on anyone offering NM theranostics with Pluvicto to their patients.

I’m developing a plan to incorporate this into our existing clinic with I-131 for thyroid therapies, and just wanted to know if anyone is actually doing it (pending availability issues) and, if so, how they set it up:

Was it a separate clinic?

What was the proximity to your PET CT service?

What were some of the key regulatory issues?

I’m working with our referring urologists to test their waters as well.

Any constructive input appreciated.  Naysayers  (I know you’re out there) are welcome as well.

 
Are you doing Lutathera therapies?  If so, the infrastructure, logistics, work/patient flow processes, and regulatory issues are similar.  You’ll need a place to administer the therapy, but my understanding is that the patient flow is much simpler than for Lutathera (i.e. renal protective infusion, Somatostatin infusion, etc.).  
 
We’re planning on starting Pluvicto therapies later this year.  As you’re aware, the rate-limiting issue has been availability.  Based on the amount of PSMA PET-CT we’ve been doing, we’re expecting robust demand.  Our PET-CT is on the hospital campus but not in the main building.  NM is part of the radiology department where I practice so there’s no separate clinic.  Our radiology nursing unit is pretty well run and setup; Lutathera therapies have been easy to implement.  As far as regulatory issues with Lutathera, the main one has been the who/where/how of the therapy; a good RSO is very helpful for this.  
 
Our urologists are pretty plugged in to latest trends and we’ve been doing quite a bit of prostate MRI and PSMA PET so it’s not surprising that several of them have inquired about Pluvicto.  If the urologists you work with don’t order much imaging relating to prostate, it may be worth contacting a Pluvicto rep to set up a [strike]sales pitch[/strike] dinner CME.  Some individual discussions between you and uro also may be helpful  

[Unknown Member]

Very helpful.
 
Thanks for the response.
 
Our urologists are very keen to stay cutting edge, and the PSMA PET CTs are going like gangbusters.  Finally, after decades of duds, we have a great way to image and serve these patients.
 
So I am hoping the Pluvicto will follow.

[Unknown Member]

Re: PSMA PET CTs
—————–
Been really impressed with results. 
Correlates well with prostate MRI.
Extremely sensitive for o/w occult metastasis.
 
 

[aldoctc]

Quote from boomer

Re: PSMA PET CTs
—————–
Been really impressed with results. 
Correlates well with prostate MRI.
Extremely sensitive for o/w occult metastasis.

 
I’m old enough to remember ProstaScint and OncoScint.  PSMA and dotatate PET are so much better.  
 

[Unknown Member]

Agreed re: PSMA PET CTs
 
I’m beginning to see that all those CT A/P + Bone Scans were what I thought they were, i.e. useless.
 
Most LNs I’m calling are in the 5-7mm range.  And we have back to back Bone Scans vs PSMA PET CT, with the Bone Scan equivocal at best, and the PSMA lighting up like a Christmas tree (and, even more remarkably, very little to call on the attenuation correction CT).
 
It’s a new era for these patients–FINALLY.
 
Now, it’s just going to get the payers to accept the new standard of care.  They will go kicking and screaming the whole way Home, until they get prostate CA…