A Revolution in the Treatment of Neuroendocrine Tumors

Patients with neuroendocrine tumors have more treatment options than ever before.
Reidy-Lagunes at MSK is participating in a trial that’s aimed at improving PRRT by attaching a protein called 177Lu-OPS201 (previously DOTA-JR11) to the radioactive particles. 177Lu-OPS201 is a somatostatin antagonist, meaning it binds to the somatostatin receptor regardless of whether it’s in an active or inactive state. Early evidence suggests it may increase the effectiveness and reduce the potential of serious side effects like kidney damage, Reidy- Lagunes says.

The treatment “binds with better affinity to the tumor itself so you’re delivering more radiation directly to the tumor — like a lock and key,” she says. A phase 1 study was put on hold so investigators could fine-tune the dosage and is now resuming at a lower dose, Reidy-Lagunes says. New treatments for carcinoid syndrome are also making their way through the development pipeline. In February 2017, the FDA approved Xermelo (telotristat ethyl), an oral drug that reduces the overproduction of seratonin that some NETs cause and, in so doing, relieves diarrhea. The drug is designed to be taken along with a somatostatin analog.

“Some of the hormones [associated with carcinoid syndrome] can be quite debilitating, so from a quality-of-life perspective, this approval was really exciting for all of us who treat the disease,” Reidy-Lagunes says. “It’s an added benefit in our armamentarium to control the symptoms of the disease.”

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