Therapy-Specific Considerations I-III (from the RPT Curriculum Supplement Series)

Topics Covered:

Therapy-Specific Considerations I - Therapy-Specific Considerations for Lu-PSMA-617
—Jeff M. Michalski, MD, MBA, FASTRO

Therapy-Specific Considerations I - Therapy-Specific Considerations for Ra-223
—Richard G. Stock, MD

Therapy-Specific Considerations II – Therapy-Specific Considerations for RAI
—Stephanie S. Markovina, MD, PhD, and Nikhil Rammohan, MD, PhD

Therapy-Specific Considerations II – Therapy-Specific Considerations for Liver-Directed Radiopharmaceutical Therapy/Selective Internal Radiation Therapy
—Andrew Kennedy, MD

Therapy-Specific Considerations III – Therapy-Specific Considerations for Lu-DOTATATE
—Hyun Kim, MD

For presentation descriptions, please see the Program tab.

This activity is available from July 19, 2024, through 11:59 p.m. Eastern time on July 4, 2026. 

The content was originally presented and recorded on May 31, 2024 in the Beyond the Beam: A Radiation Oncology Curriculum for Radiopharmaceutical Therapy webinar series, a 15-hour in-depth curriculum supplement resource designed specifically for radiation oncology residents and practicing radiation oncologists who are planning or participating in a radiopharmaceutical therapy (RPT) clinical program. Learn more about the full series.

Target Audience

The activity is designed to meet the interests of radiation oncologists, radiation physicists, dosimetrists, diagnostic radiologists, radiation biologists, medical oncologists and radiation oncology residents.   

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Describe the role of 177Lu-PSMA radioligand therapy in the management of patients with metastatic androgen insensitive (castrate resistant) prostate cancer.
  • Identify the common side effects and toxicities of 177Lu-PSMA radioligand therapy and their management.
  • Identify the role of Ra-223 in mCRPC.
  • Describe the basic mechanism of RAI therapy.
  • Discuss the indications for RAI therapy in thyroid cancer.
  • Explain the toxicities of RAI therapy.
  • Explain the eligibility criteria for a patient to be considered for liver-directed radiotherapy using Y90 (SIRT).
  • Determine the estimated absorbed dose of Y90 in tumor and normal liver prior to, and after implantation of Y90 in the liver for unresectable solid tumors.
  • Analyze the patient for Y90 treatment who has previously received hepatic external beam radiotherapy.
  • Discuss the clinical data supporting the use of lutathera therapy in neuroendocrine tumors.
  • Discuss practical considerations for delivery of lutathera.
Course summary
Available credit: 
  • 5.00 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 5.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 5.00 Certificate of Attendance
    This activity was designated for 5.00 AMA PRA Category 1 Credit™.
Course opens: 
07/19/2024
Course expires: 
07/04/2026
Cost:
$449.00
Rating: 
0

Therapy-Specific Considerations I

In this session, the presenters review the role of prostate specific membrane antigen (PSMA) in the staging, localization, and targeting of prostate cancer. Diagnostic PET imaging agents such as 18F-piflufostat, 18F-flotufolastat, and 68Ga-gozetotide are allowing more accurate detection of early recurrent prostate cancer after either prior prostatectomy or definitive radiation therapy. They can also be used to select patients that may respond to radioligand therapy that employ similar PSMA-avid ligands that are linked to a therapeutic radioisotope. The first PSMA avid radioligand is 177Lu-vipivotide tetraxetan, which has been shown to prolong survival and maintain quality of life of men with castrate resistant prostate cancer. Clinical trials with similar drugs in various prostate cancer disease states are ongoing.

The role of RA-233 and its applications are also discussed.

Therapy-Specific Considerations II

The first presentation, Therapy Specific Considerations for RAI, reviews the therapy-specific considerations for RAI toward the treatment of thyroid cancer. Discussion includes the basic mechanism, indications and toxicities of RAI therapy.

Hepatic brachytherapy using intra-arterial Y90 microspheres is a maturing therapy that often is delivered without the concomitant application of personalized dosimetry planning and post-treatment confirmatory dosimetry, multidisciplinary consultation, and collaborative management prior to and post liver-directed RPT.  The second presentation, Therapy-Specific Considerations for Liver-Directed RPT/SIRT, reviews the eligibility criteria for liver-directed radiotherapy using Y90 and the estimated absorbed does in tumor and normal live prior to and after implementation.

Therapy-Specific Considerations III

This session provides instruction on the clinical data and practical considerations for lutetium Lu 177 dotatate treatment.

  • Jeff M. Michalski, MD, MBA, FASTRO, is employed by Washington University School of Medicine in St. Louis. Dr. Michalski receives travel expenses/compensation from Michalski and Associates and receives grant/research funding from NCI. Dr. Michalski is Treasurer of the RTOG Foundation and Co-Chair of the GU Steering Committee with NCI. 
  • Richard G. Stock, MD, is employed by Icahn School of Medicine at Mount Sinai. Dr. Stock receives honoraria from Grand Rounds in Urology and Accuray.
  • Stephanie Markovina, MD, PhD, is employed by Washington University School of Medicine in St. Louis. Dr. Markovina receives travel expenses from NCCN. Dr. Markovina is the PI on research grants with the National Cancer Institute/NIH and Tesaro, Inc. 
  • Nikhil Rammohan, MD, PhD, is employed by Washington University School of Medicine in St. Louis. 
  • Andrew S. Kennedy, MD, is employed by the Sarah Cannon Cancer Center at TriStar Health. Dr. Kennedy receives compensation from ABK Medical and Bard.
  • Hyun Kim, MD, is employed by Washington University School of Medicine in St. Louis. Dr. Kim receives grant/research funding from Varian and ViewRay. Dr. Kim receives compensation from Novartis. Dr. Kim is the Founder/CEO of GlobalART. Dr. Kim is Associate Editor of IJROBP.

The person(s) above served as the developer(s) of this activity. Additionally, the Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.

Disclosure link: 
ASTRO Education Committee

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Available Credit

  • 5.00 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 5.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 5.00 Certificate of Attendance
    This activity was designated for 5.00 AMA PRA Category 1 Credit™.

Price

Cost:
$449.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

Nonmember: $449
Member: $299
Member-in-training: $79
Student/Grad Student/PGY: $79
Postdoctoral Fellow: $79

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.

Policies:

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The activity and its materials will only be available on the ASTRO website until Jul;y 4, 2026, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date.

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