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Related Concept Videos

Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when researchers try to extrapolate results...

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Related Experiment Video

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New Insights in PRRT: Lessons From 2021.

Giulia Puliani1,2, Alfonsina Chiefari1, Marilda Mormando1

  • 1Oncological Endocrinology Unit, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Regina Elena National Cancer Institute, Rome, Italy.

Frontiers in Endocrinology
|April 22, 2022
PubMed
Summary

Peptide receptor radionuclide therapy (PRRT) shows promise for neuroendocrine tumors (NETs) with expanding applications and good safety profiles. Further research is needed to identify prognostic factors for this advanced cancer treatment.

Keywords:
neuroendocrine neoplasmsneuroendocrine tumorspeptide receptor radionuclide therapypredictive factorsprognostic factorsradioligand therapysafety

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmaceutical Therapy

Background:

  • Peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogs is an established treatment for well-differentiated neuroendocrine tumors (NETs).
  • The NETTER-1 trial has reinforced the clinical utility of PRRT.
  • Ongoing discussions persist regarding various aspects of PRRT, necessitating a review of recent evidence.

Purpose of the Study:

  • To review and discuss new evidence published in 2021 concerning PRRT with 177Lu-Oxodotreotide (DOTATATE) or 90Y-Edotreotide (DOTATOC) in adult NET patients.
  • To focus on emerging clinical applications, safety data, and prognostic/predictive factors.
  • To consolidate current understanding and guide future research and clinical practice.

Main Methods:

  • Systematic review of literature published in 2021 focusing on PRRT for NETs.
  • Analysis of studies investigating novel indications, safety outcomes (short- and long-term), and prognostic/predictive factors.
  • Synthesis of evidence related to 177Lu-DOTATATE and 90Y-DOTATOC therapies.

Main Results:

  • PRRT may see expanded use in new clinical settings, including other NET types, neoadjuvant therapy, and retreatment (rechallenge).
  • Available studies indicate a favorable safety profile with low adverse event rates, though 1.8% of patients developed a second malignancy.
  • A significant gap exists in identifying prognostic and predictive factors, with nuclear imaging playing a key role in patient selection and response assessment.

Conclusions:

  • PRRT is a valuable therapeutic option for NETs with potential for broadened indications and a generally safe profile.
  • Further investigation is required to establish robust prognostic and predictive biomarkers for PRRT.
  • Nuclear imaging remains critical for optimizing PRRT patient selection and monitoring treatment efficacy.