Fascinating article from the Italian NET scientific community.  This article is more than just what the title says, it provides overviews on many facets of NETs including markers, scans and PRRT itself. It covers how to select patients for PRRT in the first place, i.e. who is most likely to get a good response to this treatment and then look at how to track and assess that response.

The important thing I gathered from reading is that none of this is a precise science, there are too many variables.  And while this article focusses on the clinical factors, there can of course be non-clinical factors in play in different countries and healthcare systems.  For example, for years in my own country (UK), access to PRRT was quite limited before formal approval and was rationed for compassionate use.  Only those with the greatest need would get access. In a similar vein, countries may have short or limited supplies, even since being formally authorised, and may therefore operate a similar rationing programme.  Even in advanced economies with advanced healthcare, there can be limits based whether a particular person has a need and in the case of insurance-based approvals, whether it can be funded within the guidelines.

For those with an interest in PRRT this is a great read but long and technical in places.   Click here to read.

This guidance document co-authored by the North American Neuroendocrine Tumors Society (NANETS) and The Society of Nuclear Medicine and Molecular Imaging (SNMMI) takes a more practical look at the selection of patients. Click here to read.

Reference:

Liberini, V.; Huellner, M.W.; Grimaldi, S.; Finessi, M.; Thuillier, P.; Muni, A.; Pellerito, R.E.; Papotti, M.G.; Piovesan, A.; Arvat, E.; Deandreis, D. The Challenge of Evaluating Response to Peptide Receptor Radionuclide Therapy in Gastroenteropancreatic Neuroendocrine Tumors: The Present and the Future. Diagnostics 2020, 10, 1083.

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).