Radiopharmaceutical Therapy

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Leading Edge Cancer Treatment

Patients diagnosed with a specific rare malignancy in the gastrointestinal tract and pancreas have another treatment choice at MUSC Health.

The peptide receptor radionuclide therapy (PRRT), Lutathera (lutetium-177 dotatate), is available at MUSC Health for the treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

“Although these cancers are considered rare, their incidence is steadily increasing,” says says Leonie Gordon, M.D., professor and director of Nuclear Medicine at MUSC.

“The majority of GEP-NETs are diagnosed at an advanced stage of disease, and systemic treatment options are limited for inoperable and metastatic tumors that progress on traditional therapies,” she says.

Studies have shown that the five-year overall survival rates for patients with distant metastases of well-differentiated disease can range from 29 to 69%.

Lutathera is recommended as a second-line therapy for these challenging cases in which the disease continues to progress while patients are on traditional somatostatin analog therapy, Gordon says.

Lutathera is a targeted therapy that acts by delivering high doses of radiation to the GEP-NET deposits throughout the body, ultimately destroying the tumor cells, slowing the progression of disease and reducing side effects associated with the disease.

It has been shown to improve the progression-free survival rates by up to 79%, according to clinical trial results.

William Rieter, M.D., and assistant professor of Radiology and Nu-clear Medicine emphasizes that patients must meet specific criteria to be considered for Lutathera therapy.

Specifically, adult patients should have well-differentiated GEP-NETs with documented somatostatin receptor positivity on a re-cent gallium-68 dotatate PET/CT scan (also known as NETSPOT) and must have shown progression on somatostatin analog therapy. “It is essential for patients to obtain a pretreatment NETSPOT scan because it not only shows us the extent of disease and expected up-take within tumor deposits, but also allows us to monitor treatment efficacy,” Rieter says.

At MUSC, Lutathera is administered in an outpatient setting in the nuclear medicine suite under the direction of Gordon and Rieter. Lutathera is given as an infusion over several hours in four doses, each eight weeks apart.

Rieter and Gordon are optimistic over Lutathera’s potential. “The introduction of a new therapy is an exciting time for clinicians, patients and researchers,” Gordon says. “We always strive to provide referring physicians and patients access to newly approved radio-pharmaceuticals as quickly as possible, and we’re gratified to be on the leading edge of this treatment.” Lutathera is one of several new radiopharmaceuticals that MUSC offers for the diagnosis and treatment of patients with cancer.