Risk for Misinterpretation
Image interpretation errors can occur with LOCAMETZ PET. Negative imaging does not rule out the presence of prostate cancer and a positive imaging does not confirm the presence of prostate cancer. ...
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Using LOCAMETZ
Image Acquisition
LOCAMETZ ALLOWS VISUALIZATION OF PSMA+ METASTASES—REGARDLESS OF LOCATION—IN ACCORDANCE WITH ESTABLISHED GUIDELINES1,2
How to acquire images using LOCAMETZ3
Image Interpretation
Recommendations for interpreting images made using LOCAMETZ follow current national and international guidelines
Information for image interpretation
- LOCAMETZ binds to PSMA. Based on the intensity of the signals, PSMA PET images obtained with gallium Ga 68 gozetotide indicate the presence of PSMA protein in tissue3
- Descriptions of location, extent, and intensity of PSMA ligand uptake are addressed in the most current SNMMI and EANM guidelines on prostate cancer imaging with gallium Ga 68 gozetotide2
- Image interpretation errors can occur with LOCAMETZ PET. Read more on the Risk for Misinterpretation warning within the Important Safety Information
EANM, European Association of Nuclear Medicine; PET, positron emission tomography; PSMA, prostate-specific membrane antigen; PSMA-, PSMA negative; PSMA+, PSMA positive; SNMMI, Society of Nuclear Medicine and Molecular Imaging.
How to Order LOCAMETZ
LOCAMETZ after radiolabeling with gallium 68 is distributed through a network of radiopharmacies
To order radiolabeled LOCAMETZ delivered ready to inject, please contact your local radiopharmacy. Or refer your patient for a PSMA PET scan at your local scanning center today.
References: 1. Hofman MS, Lawrentschuk N, Francis RJ, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multi-centre study. Lancet. Published online March 22, 2020. 2020;395(10231):1208-1216. https://doi.org/10.1016/S0140-6736(20)30314-7. 2. Fendler WP, Eiber M, Beheshti M, et al. 68Ga-PSMA PET/CT: Joint EANM and SNMMI procedure guideline for prostate cancer imaging: version 1.0. Eur J Nucl Med Mol Imaging. Published online March 10, 2017. 2017;44(6):1014-1024. doi:10.1007/s00259-017-3670-z. 3. LOCAMETZ [prescribing information]. Millburn, NJ: Advanced Accelerator Applications USA, Inc; 2022.
Indication
LOCAMETZ® (kit for the preparation of gallium Ga 68 gozetotide injection), after radiolabeling with gallium-68, is indicated for positron emission tomography (PET) of prostate-specific membrane antigen (PSMA)-positive lesions in men with prostate cancer:
- with suspected metastasis who are candidates for initial definitive therapy
- with suspected recurrence based on elevated serum prostate-specific antigen (PSA) level
- for selection of patients with metastatic prostate cancer for whom lutetium Lu 177 vipivotide tetraxetan PSMA-directed therapy is indicated
IMPORTANT SAFETY INFORMATION
Risk for Misinterpretation
Image interpretation errors can occur with LOCAMETZ PET. Negative imaging does not rule out the presence of prostate cancer and a positive imaging does not confirm the presence of prostate cancer. Gallium Ga 68 gozetotide uptake is not specific for prostate cancer and may occur with other types of cancer as well as nonmalignant processes. Clinical correlation, which may include histopathological evaluation of the suspected prostate cancer site, is recommended.
Imaging prior to initial definitive or suspected recurrence therapy
The performance of LOCAMETZ seems to be affected by serum PSA levels and by site of disease for imaging of biochemically recurrent prostate cancer, and by Gleason score for imaging of metastatic pelvic lymph nodes prior to initial definitive therapy.
Imaging to select patients for lutetium Lu 177 vipivotide tetraxetan therapy
The interpretation of LOCAMETZ PET may differ depending on imaging readers. LOCAMETZ PET interpretations to select patients for lutetium Lu 177 vipivotide tetraxetan therapy may be more consistent when judging gallium Ga 68 gozetotide uptake in any 1 tumor lesion compared with judging uptake for all lesions larger than size criteria. Multidisciplinary consultation is recommended, particularly for LOCAMETZ imaging that a single reader finds borderline or difficult to interpret, or when patient eligibility hinges only on judgment of gallium Ga 68 gozetotide uptake for all lesions larger than size criteria.
Radiation Risk
Gallium Ga 68 gozetotide contributes to a patient’s long-term cumulative radiation exposure, which is associated with an increased risk of cancer. Ensure safe handling to minimize radiation exposure to the patient and health care workers. Advise patients to be well hydrated prior to gallium Ga 68 gozetotide administration and to void immediately prior to and frequently during the first hours after image acquisition to reduce radiation exposure.
Adverse Reactions
Adverse reactions ≥0.5% in the VISION study were fatigue (1.2%), nausea (0.8%), constipation (0.5%), and vomiting (0.5%). Adverse reactions occurring at a rate of <0.5% were diarrhea, dry mouth, injection site reactions, and chills.
Please see accompanying full Prescribing Information.
