Answer to Question #1205 Submitted to "Ask the Experts"

Category: Nuclear Medicine Patient Issues — Therapeutic Nuclear Medicine

The following question was answered by an expert in the appropriate field:

I am interested in learning all I can about rhenium-186 for pain palliation for metastatic cancer in the bone. Is it Food and Drug Administration approved yet? Are there side effects? Can treatment be repeated? How long does it take before relief begins and when it does, how long will it last?

Rhenium-186 (HEDP) is not Food and Drug Administration (FDA) approved, and I don't even know whether Mallinckrodt Medical is still pursuing it. There are two other FDA-approved drugs available, ⁸⁹Sr Chloride (Metastron, Nycomed-Amersham) and ¹⁵³Sm-EDTMP (Quadramet, Berlex Laboratories). The April 2000 issue (volume 41) of the Journal of Nuclear Medicine has several useful and comprehensive articles on the subject of radiopharmaceutical therapy for bone metastases; I would recommend that you peruse these articles and use the references for further information.

If you or a member of your family is a candidate for one of these drugs, your nuclear medicine physician should give you more personalized information. If your physician doctor won't or can't answer your questions, you should insist on a different physician. Both Metastron and Quadramet are about $3,000/dose—which is expensive—and numerous managed-care plans therefore don't like to use it. You should check with your medical insurance plan for coverage.

Carol Marcus, MD

Editor's Note: Further can be found at the National Library of Medicine Web site by searching for Metastron and Quadramet.

Answer posted on September 28, 2001. The information and material posted on this Web site is intended as general reference information only. Specific facts and circumstances may alter the concepts and applications of materials and information described herein. The information provided is not a substitute for professional advice and should not be relied upon in the absence of such professional advice specific to whatever facts and circumstances are presented in any given situation. Answers are correct at the time they are posted on the Web site. Be advised that over time, some requirements could change, new data could be made available, or Internet links could change. For answers that have been posted for several months or longer, please check the current status of the posted information prior to using the responses for specific applications.