NM Therapies Radiopharm – NMTCB UPDATED ACTUAL Questions and
CORRECT Answers
Bone pain associated with diffuse bone metastasis in pa-
What is Xofigo (Ra-233) used for?
tients with prostate cancer
How is Xofigo produced? Xofi go is prepared from an Ac-227/ Ra-223 Generator.
Calcium analog which will bind to the hydroxyapatite bone
matrix.
Ra-233 MOL?
Only bone pain palliation agent to demonstrate increase
in life expectancy. Average life extension is ~3 months
Xofigo (Ra-223) dose? 1.35 μCi/kg (50 Kbq/kg).
Slow IV injection over 1 min every 4 weeks for six treat-
Xofigo (Ra-223) procedure?
ments.
Patient eligibility requirements prior to first treatment :
Xofigo (Ra-223) patient requirements? Absolute neutrophil count > 1.5 × 10 9 /L,
platelet count >100 × 10 9 /L, hemoglobin >10 g/dl
via Bowels system and feces
How is Xofigo excreted? At 4 h post injection 61 % in the bone and 39 % in the
bowel
platelet: exceed 60,000/mL and preferably 100K /mL
Ò
Sm-153 & Sr-89 Patient blood counts requirements: WBC: 2,400-3,000/ml and preferably 5,000/mL
Ò
granulocyte: 2,000/mL
Ò
Sr-89 chloride dose 4 mCi or (40-60 mCi/kg)
Sm-153 (Quadramet) dose 1 mCi/kg
Treatment of follicular low-grade non-Hodgkin's lym-
Y-90-Ibritumomab Tiuxetan Zevalin indicates for
phoma (refractory to Rituximab, relapsed or transformed)
Y-90 labeled Murine anti-CD20 monoclonal antibody ibri-
What is Zevalin?
tumomab (by chelating agent Tiuxetan)
Y-90-Ibritumomab Tiuxetan Zevalin Protocal
, Day 1: Unlabled Rituximab 250 mg/m 2.
4 hrs later - In-111 Zevalin Imaging to access bio-distrib-
ution.
Days 7-9: Unlabeled Rituximab 250 mg/m 2 follow by IV
admintration of Y-90 Zevalin 4 hrs later
0.4 mCi/kg for patients with platelets >150 K.
0.3 mCi/kg for patients with platelets between 100 and
Y-90 Ibritumomab Tiuxetan dose
150K.
Max dose of 32 mCi
This is a pic of what Y-90 ablation should look after treat-
ment.
Y-90 Zevalin Ablation Effect Pic
Treatment of somatostatin receptor-positive gastroen-
teropancreatic neuroendocrine tumors (GEP-NETs), in-
Lutetium-177 dotatate (Lutathera)
cluding foregut, midgut, and hindgut neuroendocrine tu-
mors in adults
Lu-177 dotatate (Lutathera) dose 200 mCi every 8 weeks for a total of 4 doses
patient must be off long-acting octreotide 4 wks before
treatment;
Lu-177 dotatate (Lutathera) preparation
short-acting octreotide may be administered to address
symptoms
Lu-177 dotatate (Lutathera) infusion
CORRECT Answers
Bone pain associated with diffuse bone metastasis in pa-
What is Xofigo (Ra-233) used for?
tients with prostate cancer
How is Xofigo produced? Xofi go is prepared from an Ac-227/ Ra-223 Generator.
Calcium analog which will bind to the hydroxyapatite bone
matrix.
Ra-233 MOL?
Only bone pain palliation agent to demonstrate increase
in life expectancy. Average life extension is ~3 months
Xofigo (Ra-223) dose? 1.35 μCi/kg (50 Kbq/kg).
Slow IV injection over 1 min every 4 weeks for six treat-
Xofigo (Ra-223) procedure?
ments.
Patient eligibility requirements prior to first treatment :
Xofigo (Ra-223) patient requirements? Absolute neutrophil count > 1.5 × 10 9 /L,
platelet count >100 × 10 9 /L, hemoglobin >10 g/dl
via Bowels system and feces
How is Xofigo excreted? At 4 h post injection 61 % in the bone and 39 % in the
bowel
platelet: exceed 60,000/mL and preferably 100K /mL
Ò
Sm-153 & Sr-89 Patient blood counts requirements: WBC: 2,400-3,000/ml and preferably 5,000/mL
Ò
granulocyte: 2,000/mL
Ò
Sr-89 chloride dose 4 mCi or (40-60 mCi/kg)
Sm-153 (Quadramet) dose 1 mCi/kg
Treatment of follicular low-grade non-Hodgkin's lym-
Y-90-Ibritumomab Tiuxetan Zevalin indicates for
phoma (refractory to Rituximab, relapsed or transformed)
Y-90 labeled Murine anti-CD20 monoclonal antibody ibri-
What is Zevalin?
tumomab (by chelating agent Tiuxetan)
Y-90-Ibritumomab Tiuxetan Zevalin Protocal
, Day 1: Unlabled Rituximab 250 mg/m 2.
4 hrs later - In-111 Zevalin Imaging to access bio-distrib-
ution.
Days 7-9: Unlabeled Rituximab 250 mg/m 2 follow by IV
admintration of Y-90 Zevalin 4 hrs later
0.4 mCi/kg for patients with platelets >150 K.
0.3 mCi/kg for patients with platelets between 100 and
Y-90 Ibritumomab Tiuxetan dose
150K.
Max dose of 32 mCi
This is a pic of what Y-90 ablation should look after treat-
ment.
Y-90 Zevalin Ablation Effect Pic
Treatment of somatostatin receptor-positive gastroen-
teropancreatic neuroendocrine tumors (GEP-NETs), in-
Lutetium-177 dotatate (Lutathera)
cluding foregut, midgut, and hindgut neuroendocrine tu-
mors in adults
Lu-177 dotatate (Lutathera) dose 200 mCi every 8 weeks for a total of 4 doses
patient must be off long-acting octreotide 4 wks before
treatment;
Lu-177 dotatate (Lutathera) preparation
short-acting octreotide may be administered to address
symptoms
Lu-177 dotatate (Lutathera) infusion
