Long-Term Experience Supports Efficacy and Safety of PRRT for Treating Neuroendocrine Tumors

Excerpt:

“More than ten years of published clinical data and personal experience using PRRT-based targeted therapy of neuroendocrine tumors supports the effectiveness of this novel treatment approach and the ability to minimize and manage potential toxic side effects. A comprehensive review of somatostatin analog peptide receptor radionuclide therapy (PRRT) is published in Cancer Biotherapy and Radiopharmaceuticals.”

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For Cancer Patients, Newest Treatments Force the Ultimate Decision, with No Room for Error

Excerpt:

“Three weeks earlier she’d been done. Done with the chemo and the uncertainty and the fatigue that pinned her to a bed where her husband found her sobbing after he put the boys to sleep. “When can I just pull the plug?” she asked.

“And now Rachel Lefebvre, 43, and her husband, Fred, were here, at her oncologist’s office.

“First the doctor would tell them if a last-line chemo drug had slowed the breakaway growth of her liver tumors. It had, he said, and Fred instantly grasped his wife’s knee. Now, he told them, is the time to take their one shot at one of the most promising kinds of experimental cancer treatments, known as immunotherapy.”

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SPINET Trial Could Alter Practice for Patients With Lung NETs

Excerpt:

“Since its FDA approval in 2014, the somatostatin analog lanreotide (Somatuline Depot) has been creating fresh options for select patients with gastroenteropancreatic neuroendocrine tumors (NETs), given the significant improvement in progression-free survival (PFS) demonstrated in this population.

“Now, investigators are examining the potential that the agent could have in patients with lung NETs—an area that is greatly lacking in research— in a potentially practice-changing clinical trial that seeks to determine the role of the synthetic growth inhibitory hormone in patients with the rare tumor type. Thus far, no prospective trials specifically for patients with lung NETs have been reported, researchers have noted.”

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NET Oncogene Patterns Don’t Fit the Classic Mold

Excerpt:

“Matthew H. Kulke, MD, MMSc, has been a leader in the development of new therapies and clinical management strategies for patients with neuroendocrine tumors (NETs).

“In a recent milestone, Kulke presented phase III clinical trial data at the 2015 European Cancer Congress indicating that telotristat etiprate, a novel tryptophan hydroxylase inhibitor, improves diarrhea control in combination with a somatostatin analog for patients with metastatic NETs and inadequately controlled carcinoid syndrome. In the clinical arena, Kulke serves as co-chair for the National Comprehensive Cancer Network guidelines panel on NETs and also is an active member of medical society advisory boards and task forces related to NETs.”

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Excitement Continues to Build for Advances in Neuroendocrine Tumor Field

Excerpt:

“It’s been an exciting year thus far for patients with neuroendocrine tumors (NETs), with the FDA approving a new treatment regimen and more advancements on the horizon, according to James C. Yao, MD, a professor in the Department of Gastrointestinal (GI) Medical Oncology at The University of Texas MD Anderson Cancer Center.

“In February, the FDA approved everolimus (Afinitor) as a treatment for patients with progressive, well-differentiated, non-functional NETs of GI or lung origin with unresectable, locally advanced or metastatic disease. The mTOR inhibitor has been approved since 2011 for unresectable or advanced pancreatic NETs.

“Meanwhile, the agency is evaluating Lutathera (177Lutetium DOTA-octreotate), a peptide receptor radionuclide therapy (PRRT), for patients with gastroenteropancreatic NETs under its priority review program. Similarly, telotristat etiprate, a small-molecule tryptophan hydroxylase inhibitor, also is being considered under the FDA’s priority review program for carcinoid syndrome in patients with metastatic NETs.”

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Advanced Accelerator Applications Announces FDA Priority Review for Lutathera

Excerpt:

“Advanced Accelerator Applications S.A…, an international specialist in Molecular Nuclear Medicine (MNM), today announced that the U.S. Food and Drug Administration (FDA) has accepted the company’s New Drug Application (NDA) and granted Priority Review for Lutathera, a Lu-177-labeled somatostatin analogue peptide currently under development for the treatment of gastro entero pancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults. The Prescription Drug User Fee Act (PDUFA) target action date is December 28, 2016.

“Priority review is assigned to applications for drugs that treat serious conditions and would, if approved, provide significant improvements in the safety or effectiveness of the treatment, diagnosis or prevention of serious conditions.”

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Everolimus Survival Benefit Suggested in Updated NET Trial Results

Excerpt:

“Patients with nonfunctioning neuroendocrine tumors (NETs) of lung or gastrointestinal (GI) origin continued to live longer when treated with the mammalian target of rapamycin (mTOR) inhibitor everolimus (Afinitor) than with placebo, ongoing follow-up in a randomized trial has shown.

“A second planned interim analysis of the RADIANT-4 trial showed a 27% reduction in the estimated risk of death for patients who received everolimus compared with placebo. However, the difference did not meet the statistical threshold for overall survival (OS) significance.

“As previously reported, the trial met the primary endpoint of progression-free survival (PFS), and a first interim survival analysis showed a trend in favor of the everolimus arm. Follow-up for survival will continue, James C. Yao, MD, a professor at The University of Texas MD Anderson Cancer Center, reported at the 2016 ASCO Annual Meeting.”

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Blood Test Predicts Success of Neuroendocrine Cancer Therapy

Excerpt:

“Malignant neuroendocrine tumors (NETs) are relatively rare, notoriously difficult to treat, and associated with poor long-term survival. According to research presented at the 2016 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), an investigative blood test could predict how patients will respond to peptide receptor radionuclide therapy (PRRT) before they commit to a course of treatment.

“Cancerous NETs can develop in a variety of places where hormone signaling occurs between nerve cells and organs of the endocrine system, but the most common origins of these tumors are in the gastrointestinal tract, the lungs and the pancreas. These cancers sneak up on oncologists due to their rarity and the fact that symptoms such as flushing, diarrhea and sweating are often regarded as unrelated to disease and part of normal life events. Most cases are not caught until these tumors have already spread to other organs, making them difficult to treat with conventional means. A targeted treatment established in the early 2000s called peptide receptor radionuclide therapy (PRRT) zeros in on active peptide receptors that are over-expressed on the surface of NETs. The injected drug binds specifically to these receptors and knocks out tumors by irradiating them with a powerful dose of short-range radioactive material while sparing healthy tissues nearby.”

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A Better Way to Diagnose and Manage Neuroendocrine Tumors

Excerpt:

“A recent study reported in the May issue of The Journal of Nuclear Medicine demonstrates that Ga-68 DOTATATE PET/CT scans are superior to In-111 pentetreotide scans, the current imaging standard in the United States for detecting neuroendocrine tumors (NETS), and could significantly impact treatment management.

“NETS occur mostly in the respiratory and digestive tracts and are usually slow-growing. They can be difficult to diagnose, and many treatment options exist. It’s therefore critical to delineate the extent of disease accurately for proper management. While the incidence of NETS is relatively low, with 2.5-5 cases per 100,000 in the United States, data from the National Cancer Institute show a five-fold increase worldwide from 1973 to 2004. NETS can be malignant and, although they comprise less than two percent of gastrointestinal cancers, they are more prevalent than stomach and pancreatic cancers combined.”

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