Newly-Approved Therapy Provides Improved Quality of Life for Midgut Neuroendocrine Tumor Patients

Excerpt:

“Midgut neuroendocrine tumors are a rare type of cancer that develops in the small intestine and colon. Roughly 12,000 people are diagnosed with this disease each year. In January, the United Stated Food and Drug Administration approved Lutathera, a first-of-its-kind peptide receptor radionuclide therapy. The injection consists of a somatostatin analog combined with a radioactive isotope that directly targets neuroendocrine tumor cells.

“Dr. Jonathan Strosberg, head of Neuroendocrine Tumor Program at Moffitt ‘Treatment options have been limited for  with neuroendocrine tumors and toxicities of treatment can often outweigh the benefit. Our studies have shown Lutathera is an effective option to treat tumor progression and also provide patients with a better  of life,’ said Jonathan R. Strosberg, M.D., head of the Neuroendocrine Tumor Program at Moffitt Cancer Center.”

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FDA Approves New Treatment for Certain Digestive Tract Cancers

Excerpt:

“The U.S. Food and Drug Administration today approved Lutathera (lutetium Lu 177 dotatate) for the treatment of a type of cancer that affects the pancreas or gastrointestinal tract called gastroenteropancreatic neuroendocrine tumors (GEP-NETs). This is the first time a radioactive drug, or radiopharmaceutical, has been approved for the treatment of GEP-NETs. Lutathera is indicated for adult patients with somatostatin receptor-positive GEP-NETs.”

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Chemotherapy Drug Maintains Quality of Life Despite Side Effects

Excerpt:

“Patients with advanced neuroendocrine tumors (NETs) reported similar health-related quality of life (HRQOL) during treatment with a recently approved chemotherapy drug as compared to patients receiving a placebo treatment, according to a clinical trial published in Lancet Oncology.

“These findings, in conjunction with previous research showing delayed disease progression, suggest the drug, called everolimus, may be able to preserve quality of life even in light of chemotherapy’s often-toxic side effects. The findings support the usefulness of HRQOL as an endpoint in clinical trials studying NETs, in a secondary analysis of their findings, according to the study.”

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Good Outcomes with Cabozantinib in Carcinoid, PNET Tumors

Excerpt:

“Treatment with cabozantinib was tied to objective tumor responses and promising progression-free survival (PFS) in patients with advanced carcinoid and pancreatic neuroendocrine tumors (pNET), researchers reported here.

“With a daily cabozantinib (Cabometyx, Cometriq) treatment, 15% of 20 patients with pNET achieved partial response (95% CI 5-36%) and 75% achieved stable disease (95% CI 53-89%), which was the the trial’s primary endpoint, according to Jennifer Chan, MD, MPH, of the Dana-Farber Cancer Institute in Boston, and colleagues.”

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Challenges in Creating a Multidisciplinary Practice for Patients With NETs

Excerpt:

“Bringing coordinated multidisciplinary cancer treatment together into one place is ideal to improve care for patients with neuroendocrine tumors (NETs), according to David C. Metz, MD, who spoke to the challenge of establishing a multidisciplinary clinical practice for patients with NETs during a presentation at the 10th Annual NANETS Symposium in Philadelphia, Pennsylvania.”

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FDA Accepts Resubmission of Lutathera NDA for GEP-NETs

Excerpt:

“The FDA has accepted a resubmitted new drug application (NDA) for Lutathera (lutetium [177Lu] oxodotreotide) for the treatment of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Under the Prescription Drug User Fee Act, the FDA is scheduled to make a final approval decision on or before January 26, 2018.

“The NDA is based on the phase III NETTER-1 trial, which compared Lutathera with high-dose octreotide LAR for patients with grade 1 or 2 metastatic midgut NETs. In this trial, there was a 79% reduction in the risk of progression or death with Lutathera compared with octreotide.”

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Targeted Radionuclide Treatment for Neuroendocrine Tumors Improves Quality of Life

Excerpt:

“Malignant neuroendocrine tumors, commonly called NETs, are easy to miss and associated with discouraging survival rates and poor quality of life. A study presented at the 2017 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) shows how a novel peptide receptor radionuclide therapy (PRRT) is significantly improving patient wellbeing.

“In the NETTER-1 Phase III Trial, a randomized prospective study, researchers focused on advanced midgut NETs and reviewed patient-reported quality of life questionnaires following treatment with lutetium-177 (177Lu)-octreotate PRRT, also known as 177Lu-DOTATATE—brand name Lutathera. Treatment with Lutathera provided some relief for neuroendocrine cancer patients in the study when compared to high-dose octreotide, used as a control.”

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Personalized PRRT Improves Radiation Delivery to Neuroendocrine Tumors

Excerpt:

“Neuroendocrine cancer is exceedingly difficult to manage and unlikely to be cured, but researchers intend to slow progression of these tumors and aid survival by personalizing patient dose of peptide-receptor radionuclide therapy (PRRT), according to research presented at the 2017 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

“PRRT has become a of choice for relatively rare and easy-to-overlook neuroendocrine tumors (NETs). The targeted treatment is designed to home in on and attach to peptide-receptor positive tumors, while sparing tissues that might otherwise be damaged by systemic treatments. However, researchers are still perfecting the practice.”

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Flu Vaccine in Lung Cancer Patients Could Increase Immunotherapy Toxicities

Excerpt:

“Seasonal influenza vaccination resulted in increased risk of immune-related adverse events (AEs) in lung cancer patients treated with PD-1/PD-L1 checkpoint inhibitors in a small study. However, the risks of the flu itself may still outweigh the risks associated with vaccination.

” ‘Use of immune checkpoint inhibitors is now standard clinical practice for many oncology patients, and these same patients—particularly those with lung cancer—also face increased risk for complications from influenza,’ said Sacha Rothschild, MD, PhD, of University Hospital Basel in Switzerland, in a press release. ‘Although routine influenza vaccination has long been recommended for cancer patients, there are concerns that it might trigger an exaggerated immune response in this subgroup receiving checkpoint inhibitors.’ ”

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