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  • Alexander Haug

When is a Lu-DOTATATE (PRRT therapy) useful for patients with neuroendocrine tumours?

Neuroendocrine Tumours (NET) are rare cancers that arise from hormone-producing cells, some of which can produce and release specific hormones that can cause severe symptoms. NET usually grow slowly and unnoticed at first and are often diagnosed very late because of the wide variety of symptoms. Therefore, metastases are often already found in the liver at the time of diagnosis. NETs vary greatly in their behaviour according to the place of origin, extent of metastasis, and speed of growth. Therefore, there are many possible therapies, such as peptide-mediated radioreceptor therapy (PRRT) with Lu-DOTATATE.

What happens during Lu-DOTATATE (PRRT) therapy?

This is a radiation therapy in which a protein (DOTATATE) that binds to special receptors is labelled with the radioactive 177Lutetium, thus enabling targeted radiation of cancer cells. This works like a key that recognizes the appropriate lock. Based on this, radioactivity accumulates in the tumour tissue and irradiates it very specifically from the inside while sparing the healthy tissue as much as possible.

Half an hour before the start of treatment, amino acids are given via an infusion to protect the kidneys. The labelled protein is then injected via the vein and reaches the tumours with pinpoint accuracy, which are thus irradiated internally. Medications may be administered concomitantly. The treatment lasts about 15 minutes and is repeated after 8 - 12 weeks.

Tolerance of irradiation

Lu-DOTATATE (PRRT) therapy is well tolerated in most cases, with few side effects that affect quality of life. Rarely, nausea (or vomiting) has been observed in the first 24 hours after therapy. Transient mild bone marrow depression is the most common side effect for about one in four patients; this usually does not require any additional measures or therapies.

Conditions for feasibility

1. The metastases caused by the cancer must be able to store sufficient DOTATATE so that the radiation can also reach all cancer cells. A DOTATATE PET CT (positron emission tomography with computed tomography) is used to check beforehand whether there is sufficient storage capacity.

2. The blood values must be examined in detail beforehand, and the result must be good enough, e.g. regarding the haemoglobin values, because radiation therapy can also always damage the bone marrow and thus could promote anaemia.

3. There must be adequate renal function since Lu-DOTATATE is excreted by the kidneys.

Outpatient or inpatient?

In most cases, Lu-DOTATATE (PRRT) therapy is performed as an inpatient procedure in a hospital. At Dr. Haug's office, we perform the therapy exclusively on an outpatient basis. We can therefore treat your NET with this innovative therapy. A lot of experience with NET is necessary to choose the right therapy! We will always have a detailed discussion for the individual planning of the therapy, considering your medical history.

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