Peptide Receptor Radionuclide Therapy | Atrium Health

By Derek McHaffie, MD and Roshan Prabhu, MD

Traditionally, treatment for advanced neuroendocrine tumors that affect the pancreas or gastrointestinal tract (GEP-NETs) has been limited to chemotherapy or hormone therapy. While these treatments can be effective, patients need a wider array of options, especially if they have metastatic neuroendocrine tumors. Fortunately, a new radiation therapy in the form of a drug – a treatment known as peptide receptor radionuclide therapy (PRRT) – is changing the game.

A PRRT called Lutathera has been approved for neuroendocrine tumors, and it offers an effective, well-tolerated alternative to chemotherapy. In fact, the recent NETTER-1 study showed that this drug helped 65% of patients with advanced tumors reach at least 20 months of progression-free survival, while just 10% of patients on standard therapy achieved that milestone. Atrium Health Levine Cancer jumped at the opportunity to be the first center in our region offering this leading-edge treatment.

Who’s Eligible for Peptide Receptor Radionuclide Therapy?

Patients are candidates if:

• They have metastatic and well-differentiated, GI neuroendocrine cancer that is somatostatin receptor–positive.
• Their original hormonal therapy isn’t working, and they aren’t candidates for surgery.
• They have a positive octreotide scan or gallium PET scan.

How Does the Treatment Work?

The new drug links a radioactive isotope, called Lutetium 177, with a targeting molecule that binds to somatostatin receptors on neuroendocrine tumors. This allows delivery of effective doses of radiation, over a range of only a few millimeters, directly to the tumor. This can shrink or kill tumors, while minimizing damage to healthy tissue and organs.

Patients receive a total of four infusions. These are provided once every two months, and delivered in conjunction with standard hormonal treatments.

Why Levine Cancer?

Levine Cancer uses a multidisciplinary, team approach to care for patients with neuroendocrine tumors. Our experts in GI medical and radiation oncology work closely to coordinate treatment, and our expertise in PRRT – combined with our specialized facility – helps us give patients the best chance at a good outcome.

Levine Cancer’s nuclear medicine technicians and nurses have advanced training in their field, and work hand-in-hand with our radiation oncologists, radiation safety team and physics staff to provide safe, attentive care throughout treatment. Our nuclear medicine team is also equipped with the latest diagnostic technology, including a gallium–68 dotatate PET scan that offers the most accurate staging for this disease.

We have already used this new radioactive drug to slow progression for more than 25 patients.

How to Refer

Levine Cancer’s experienced care coordinators work closely with referring physician offices to facilitate convenient treatment. This gives your patients access to highly specialized forms of radiation while remaining under your care.

For more information or to refer a patient, call 980-442-1100.