New lifeline for patients with inoperable neuroendocrine cancers

A novel drug, Lutetium-DOTATATE (Lutathera), has been found to have significantly lowered the risk for disease progression or death among patients with previously treated, advanced midgut neuroendocrine tumors, according to the phase III results of the NETTER-1 trial . Compared with patients treated with octreotide LAR 60 mg, treatment with 177Lutetium-DOTATATE resulted in about an 80% decreased risk for progression or death.

This phase III trial tested 177Lutetium-DOTATATE, a peptide receptor radionuclide therapy (PRRT) that combines hormone therapy and radiotherapy. The study included 230 patients with inoperable, progressive disease and randomly assigned them to four administrations of 177Lutetium-DOTATATE 7.4 GBq every 8 weeks or octreotide LAR 60 mg every 4 weeks.

At data analysis, 23 patients in the 177Lutetium-DOTATATE group had confirmed disease progression or death compared with 67 patients in the octreotide group.

In addition to this exciting development, ENETS have established a rigorous quality procedure for the accreditation of Centres of Excellence in the treatment of neuroendocrine tumours. This programme is extremely successful with 34 centres now accredited and a further three, two in the UK and the first of its kind in Poland, to receive accreditation at the conference. ENETS presented the auditing process to European Parliament in Brussels and it may yet serve as a paradigm for the planned European Reference Networks.

"Exciting new data with pharma sponsored trials such as Lutetium-DOTATATE as well as other recent clinical trials such as RADIANT 4 with everolimus and TELESTAR with telotristat etiprate together with ENETS work leading the way in developing accredited new centres of excellence, offers real hope for many patients with advanced endocrine cancer whose second-line therapeutic options have been so limited," explains Professor Martyn Caplin, International Gastrointestinal and Pancreatic Cancer specialist.

"With the results of the Netter-1 trial and the significant ongoing work to demonstrate the effectiveness of other PRRT agents, hopefully the door will now open to making this therapy available and affordable throughout the US and around the world " said Ron Hollander, Executive Director of the Neuroendocrine Tumor Research Foundation and President of the International Neuroendocrine Cancer Alliance (INCA)."