177Lu dotatate peptide receptor radionuclide therapy (PRRT) is approved by the FDA for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors.
PRRT with 177Lu dotatate binds to somatostatin receptors found on neuroendocrine tumor cells. The attached radionuclide delivers targeted radiation to kill these tumor cells. Specifically, 177Lu emits beta radiation to damage tumor cell DNA, ultimately destroying malignant cells.
The FDA approval was based on the results of the NETTER-1 phase 3 clinical trial. This trial demonstrated:
- Improved progression-free survival - Patients treated with 177Lu dotatate had a median PFS of 28.4 months compared to 8.4 months in the control group who received high-dose octreotide LAR. This represented a 79% reduction in risk of disease progression or death with 177Lu dotatate treatment.
- Acceptable safety profile - The most common severe adverse reactions were lymphopenia, neutropenia, thrombocytopenia, and vomiting. These side effects were manageable with dose adjustments and modern supportive care. There were no reported cases of renal toxicity.
Indications
177Lu dotatate PRRT is approved for:
- Treatment of adult patients with metastatic, progressive midgut NETs. This includes tumors originating from the:
- Distal small intestine
- Appendix
- Right colon
- Ascending colon
- Cecum
- Treatment of adult patients with metastatic, progressive pancreatic NETs.
- Treatment of adult patients with metastatic, progressive lung or gastrointestinal tract (stomach, gallbladder, distal colon) NETs (foregut and hindgut tumors) that are somatostatin receptor-positive.
Essentially, 177Lu dotatate PRRT is approved for treatment of GEP-NETs except those originating from the rectum.
Approximately 90% of GEP-NETs and 80-90% of lung NETs express somatostatin receptors detectable by an octreotide scan and are thus eligible for PRRT.
Contraindications
- History of hypersensitivity reactions to dotatate or lutetium Lu 177.
At
Renewal Hormone Clinic, we offer cutting-edge PRRT with 177Lu dotatate for qualifying patients with metastatic, progressive NETs. Our world-class nuclear medicine physicians have extensive experience using advanced molecular imaging and therapies to treat cancer. Contact us today to find out if you are eligible for this innovative therapy.
This therapy represents a major advancement in the treatment paradigm for NETs. By harnessing the power and precision of molecular medicine, targeted radiotherapy provides outcomes unattainable with traditional chemotherapy. With an
acceptable safety profile and
proven efficacy for prolonging
progression-free survival, 177Lu dotatate PRRT fills an important unmet need for patients with somatostatin receptor-positive GEP-NETs and lung NETs.
