Clinical dose formulation and evaluation of ¹⁷⁷Lu-DOTA-bisphosphonate: a next generation radiopharmaceutical for palliative care of painful bone metastases

In recent years, a new macrocyclic bisphosphonate ligand, namely, (4- (((bis(phosphonomethyl))carbamoyl)methyl)-7,10-bis(carboxymethyl)-1,4,7,10- tetraazacyclododec-1-yl)acetic acid (BPAMD) showed improved uptake osteoblastic lesion sites when labeled with ⁶⁸Ga for PET imaging and ¹⁷⁷Lu for palliative care. We report herein an easily adaptable strategy for the expedient formulation of clinical dose of ¹⁷⁷Lu-BPAMD using moderate specific activity ¹⁷⁷Lu produced via (n, γ) route and its preliminary clinical investigation. We believe that adaptation of this strategy would enable a large number of nuclear medicine centres to use this promising radiopharmaceutical routinely. The objective of the present study, viz. development of a protocol for formulation of clinical doses of ¹⁷⁷Lu-BPAMD using moderate specific activity ¹⁷⁷Lu for its routine use has been accomplished