Cabozantinib Active in Carcinoid Tumors and Pancreatic NETs

Excerpt:

“Cabozantinib (Cabometyx) demonstrated promising clinical activity in patients with carcinoid tumors and pancreatic neuroendocrine tumors (NETs) in a phase II trial.

“Patients with advanced carcinoid tumors (n = 41) or pancreatic NETs (n = 20) were enrolled in parallel cohorts. Both groups received 60 mg of oral cabozantinib daily and were restaged every 2 months for the first 6 months, and then every 3 months.”

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Kulke Sheds Light on Emerging Agents for Neuroendocrine Tumors

Excerpt:

“Several emerging agents are rapidly advancing the treatment paradigm for patients with neuroendocrine tumors (NETs).

“Lutathera (lutetium Lu 177 dotate) was approved by the FDA in January 2018 for patients with somatostatin receptor–positive gastroenteropancreatic NETs. The approval follows the findings of the phase III NETTER-1 trial, which demonstrated a 79% reduction in the risk of progression or death with Lutathera compared with octreotide LAR.”

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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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New Guidelines on Clinical Trial Design for Patients with Brain Metastases

Excerpt:

“Clinical trials of new anti-cancer therapies have often excluded patients whose disease has spread to the brain or central nervous system (CNS) or, if such patients were allowed on trial, trials have often failed to clearly capture information on the drug’s effect in the brain. Today new guidelines from an international, multidisciplinary group published in the journal Lancet Oncology describe how to most appropriately address cancer patients with CNS involvement within clinical trials of anti-cancer drugs.”

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Cancer Clinical Trials Exclude Many Desperate Patients. Should That Change?

Excerpt:

“When 29-year-old Carly Bastiansen was diagnosed in January 2016 with advanced pancreatic cancer, doctors told her a clinical trial was her best shot at slowing the notoriously quick-killing and hard-to-treat disease. She found one that appeared promising and went through the screening process. But the trial would not accept her.

“ ‘Participating in a clinical trial is really my only chance at living longer,’ Bastiansen, a children’s librarian in Baltimore, said this fall as she was growing weaker. ‘To have had that option taken off the table was devastating.’ ”

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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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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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