Neuroendocrine cancer halted by chemo-radionuclide therapy

Advanced cancer of the neuroendocrine system can lead to dismal prognoses, but a novel therapy is packing a punch by uniting powerful radionuclide treatment and chemotherapy drugs. This study was shared by researchers at the 2014 Society of Nuclear Medicine and Molecular Imaging Annual Meeting in St. Louis, Missouri.

The research findings show that the experimental therapy led to stabilization or regression of patients' cancer in about 70% of cases per year after completion of the treatment, now called peptide receptor chemo-radionuclide therapy (PRCRT). The therapy is just catching on across Europe and Australia and is now in clinical trials in the United States. 

“Results of this study suggest that PRCRT is a highly effective treatment option for patients with progressive NETs [neuroendocrine tumors] with high somatostatin receptor expression,” explained Grace Kong, MBBS, principal investigator for this study. It was conducted at the Centre for Cancer Imaging, Peter MacCallum Cancer Centre in Melbourne, Australia.

NETs develop within a multiplicity of organs throughout the body that have nerve cells and interact with the endocrine system through chemical signaling made possible with various hormones. These tumors usually develop along the intestines and lungs, but they can also be found in the pancreas and many other sites, although rarely.

For this study, researchers observed patients who had undergone at least three courses of treatment with Lutetium-177 DOTA-Octreotate, which is prescribed for inoperable patients with NETs expressing somatostatin hormone receptors. This study included a high proportion of grade 2 disease, which is more aggressive and associated with adverse prognosis. Researchers added a radio-sensitizing chemotherapy for 63 of the 68 patients in the study.

All of these steps together produced encouraging responses in a majority of subjects, with 72% survival at two years. More than half of patients were still alive past the five-year mark after therapy.

“The high objective response and long median survival even in patients with more aggressive tumor biology warrant further studies comparing it with other targeted therapies recently approved, despite much lower response rates,” Kong added.

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