{"id":340139,"date":"2017-03-11T01:00:00","date_gmt":"2017-03-11T00:00:00","guid":{"rendered":"https:\/\/medizinonline.com\/radiopeptide-therapy-successful-in-disease-progression\/"},"modified":"2017-03-11T01:00:00","modified_gmt":"2017-03-11T00:00:00","slug":"radiopeptide-therapy-successful-in-disease-progression","status":"publish","type":"post","link":"https:\/\/medizinonline.com\/en\/radiopeptide-therapy-successful-in-disease-progression\/","title":{"rendered":"Radiopeptide therapy successful in disease progression"},"content":{"rendered":"<p><strong>Patients with advanced, progressive somatostatin receptor-positive neuroendocrine tumors (NET) of the midgut may benefit from so-called peptide-mediated radioreceptor therapy (PRRT), according to a publication in the New England Journal of Medicine. One targets the tumor with radiolabeled somatostatin-analog peptides. Prolonged both progression-free survival and response rate were compared with the high-dose somatostatin analog octreotide LAR (intramuscular at a dose of 60 mg every four weeks). Final data on overall survival are currently pending.<\/strong><\/p>\n<p> <!--more--> <\/p>\n<p>For PRRT, the phase 3 trial in question [1] used <sup>177Lutetium dotatate<\/sup>, a Lu-177-labeled somatostatin analog peptide. Neuroendocrine tumor cells usually have a high density of somatostatin receptors. The somatostatin-analog peptide reaches the receptor in question on the tumor cell and remains there for several days. Meanwhile, 177Lutetium, a radioactive particle, ensures that the surrounding tumor cells are irradiated and killed. It is therefore an internal targeted irradiation.<\/p>\n<p>These were randomized to 116 participants who received four intravenous infusions along with the best possible concomitant therapy, which included octreotide LAR intramuscularly at a dose of 30 mg. The remaining 113 patients underwent octreotide LAR therapy alone at the above dose.<\/p>\n<h2 id=\"survival-data-give-hope\">Survival data give hope<\/h2>\n<p>The primary endpoint was defined as progression-free survival. Secondary endpoints included response rate and overall survival, for which only a preliminary interim analysis is currently available.<\/p>\n<ul>\n<li>At 20 months, calculated PFS rates were 65.2% vs. 10.8% in the control group. Consequently, the risk of progression or death was significantly reduced by 79% with PRRT (risk ratio 0.21; 95% CI 0.13-0.33; p&lt;0.0001).<\/li>\n<li>The interim analysis for overall survival was in the same direction: 14 vs. 26 deaths occurred in the two groups (p=0.004).<\/li>\n<li>Response was also significantly improved in the 177Lutetium Dotatate group, from 3% to 18% compared with the control group.<\/li>\n<\/ul>\n<p>Clinically significant myelosuppression occurred in less than 10% of patients in the study group: Compared to zero patients in the control group, neutropenia occurred in 1%, thrombocytopenia in 2%, and lymphopenia in 9% of those treated (each of grade 3-4). Toxic effects on the kidney were not found with simultaneous administration of a renal-protective agent &#8211; at least during this study period.<\/p>\n<h2 id=\"the-progression-of-the-disease-is-a-challenge\">The progression of the disease is a challenge<\/h2>\n<p>Currently, treatment options are limited for individuals with advanced NET of the midgut who demonstrate disease progression with first-line treatment with a somatostatin analog. The results of the study are therefore promising and give hope for a new treatment alternative. Especially the objective response rates are impressive and were not expected in this collective. One can be curious about the final data of the planned final analysis.<\/p>\n<p>&nbsp;<\/p>\n<p>Literature:<\/p>\n<ol>\n<li>Strosberg J, et al: Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med 2017; 376: 125-135.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><em>InFo ONCOLOGY &amp; HEMATOLOGY 2017; 5(1): 3.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Patients with advanced, progressive somatostatin receptor-positive neuroendocrine tumors (NET) of the midgut may benefit from so-called peptide-mediated radioreceptor therapy (PRRT), according to a publication in the New England Journal of&hellip;<\/p>\n","protected":false},"author":7,"featured_media":64263,"comment_status":"closed","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"pmpro_default_level":"","cat_1_feature_home_top":false,"cat_2_editor_pick":false,"csco_eyebrow_text":"Advanced NET of the midgut","footnotes":""},"category":[11391,11500,11370,11548,11503],"tags":[39283,39302,39300,39293],"powerkit_post_featured":[],"class_list":["post-340139","post","type-post","status-publish","format-standard","has-post-thumbnail","category-gastroenterology-and-hepatology","category-news-en","category-oncology","category-rx-en","category-studies","tag-net-en","tag-peptide-en","tag-prrt-en","tag-somatostatin-en","pmpro-has-access"],"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-05-16 03:12:52","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"wpml_current_locale":"en_US","wpml_translations":{"fr_FR":{"locale":"fr_FR","id":340157,"slug":"le-traitement-par-radiopeptide-est-efficace-en-cas-de-progression-de-la-maladie","post_title":"Le traitement par radiopeptide est efficace en cas de progression de la maladie","href":"https:\/\/medizinonline.com\/fr\/le-traitement-par-radiopeptide-est-efficace-en-cas-de-progression-de-la-maladie\/"},"it_IT":{"locale":"it_IT","id":340170,"slug":"la-terapia-con-radiopeptidi-ha-successo-nella-progressione-della-malattia","post_title":"La terapia con radiopeptidi ha successo nella progressione della malattia","href":"https:\/\/medizinonline.com\/it\/la-terapia-con-radiopeptidi-ha-successo-nella-progressione-della-malattia\/"},"pt_PT":{"locale":"pt_PT","id":340183,"slug":"terapia-de-radiopeptideos-bem-sucedida-na-progressao-da-doenca","post_title":"Terapia de radiopept\u00eddeos bem sucedida na progress\u00e3o da doen\u00e7a","href":"https:\/\/medizinonline.com\/pt-pt\/terapia-de-radiopeptideos-bem-sucedida-na-progressao-da-doenca\/"},"es_ES":{"locale":"es_ES","id":340186,"slug":"la-terapia-con-radiopeptidos-tiene-exito-en-la-progresion-de-la-enfermedad","post_title":"La terapia con radiop\u00e9ptidos tiene \u00e9xito en la progresi\u00f3n de la enfermedad","href":"https:\/\/medizinonline.com\/es\/la-terapia-con-radiopeptidos-tiene-exito-en-la-progresion-de-la-enfermedad\/"}},"_links":{"self":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/340139","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/comments?post=340139"}],"version-history":[{"count":0,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/posts\/340139\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media\/64263"}],"wp:attachment":[{"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/media?parent=340139"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/category?post=340139"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/tags?post=340139"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/medizinonline.com\/en\/wp-json\/wp\/v2\/powerkit_post_featured?post=340139"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}