Peptide Receptor Radionuclide Therapy (PRRT) has been around for a while and doctors are learning all the time about the most likely candidates. Selection of candidates and predictions on who will benefit most are still not an exact science (….and possibly never will be).  Neuroendocrine Neoplasms are a heterogenous grouping of cancers, and heterogeneity also includes (but is not limited to) age, stage, gender, functional/non-functional, and pre-existing condition constraints. All of this complicates the task of therapeutic decision-making and sequencing.

The attached cohort study aims to bound the issue and describe a method of allocating a Clinical Score (CS) to assist doctors and patients in their decision-making. According to the lead author, the CS is the initial prognostic score to help NET patients anticipate expected benefit from PRRT and is ready for use in the clinic (although the actual document does suggest it requires prospective confirmation from ongoing clinical trials).

This is progress.

Conclusions

This cohort study has found the Clinical Score (CS) to be the first validated clinical metric, to our knowledge, which can estimate the anticipated benefit from ¹⁷⁷Lu-dotatate for individual patients. Our study findings suggest that using ¹⁷⁷Lu-dotatate when patients are less pretreated and possess a lower degree of metastatic involvement may optimize treatment outcomes; this notion, however, requires prospective confirmation from ongoing clinical trials. Click on the heading below to read.

External Validation of a Clinical Score for Patients With Neuroendocrine Tumors Under Consideration for Peptide Receptor Radionuclide Therapy | Oncology | JAMA Network Open | JAMA Network (click here)

Original InvestigationOncologyJanuary 19, 2022

External Validation of a Clinical Score for Patients With Neuroendocrine Tumors Under Consideration for Peptide Receptor Radionuclide Therapy

Satya Das, MD, MSCI¹; Aman Chauhan, MD²; Liping Du, PhD³; Katharine E. Thomas, MD⁴; Aasems Jacob, MD²; Aimee Schad, MD⁵; Shikha Jain, MD⁶; Aaron Jessop, MD, MBA⁷; Chirayu Shah, MD⁷; David Eisner, NP-C¹; Dana B. Cardin, MD, MSCI¹; Kristen K. Ciombor, MD, MSCI¹; Laura W. Goff, MD, MSCI¹; Marques Bradshaw, MD, MSCR⁷; Dominique Delbeke, MD, PhD⁷; Martin Sandler, MD⁷; Robert A. Ramirez, DO¹; Jordan Berlin, MD¹

Author Affiliations Article Information

• ¹Division of Hematology and Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
• ²University of Kentucky Markey Cancer Center, Lexington
• ³Department of Biostatistics, Vanderbilt University of Medical Center, Nashville, Tennessee
• ⁴Division of Hematology and Medical Oncology, Department of Medicine, Lousiana State University, New Orleans
• ⁵Department of Medicine, Rush Medical Center, Chicago, Illinois
• ⁶Department of Medicine, University of Illinois Chicago, Chicago
• ⁷Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee

JAMA Netw Open. 2022;5(1):e2144170. doi:10.1001/jamanetworkopen.2021.44170

Further reading:

All you need to know about Peptide Receptor Radionuclide Therapy (PRRT) – Ronny Allan – Living with Neuroendocrine Cancer

Click on the photo to read:

I wrote about another paper from Italy which looks at the issues of selecting patients and evaluating responses to PRRT – click on the picture below to read.

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Thanks for reading.

Ronny

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