Project title: Increasing the therapeutic window in PRRT with long-acting SSAs

Description

Dr. de Vries-Huizing and her colleagues will perform a clinical trial to evaluate the effect of using long-acting somatostatin analogues during peptide receptor radionuclide therapy (PRRT).  Current guidelines advise temporary discontinuation of somatostatin analogues while continuous use could prevent increased functional symptoms like flushing and diarrhea.

What critical NET problem/question will researchers try to answer?

Long-acting somatostatin analogues (like lanreotide and octreotide) and PRRT all target the somatostatin receptor to treat NET tumors. Although current guidelines recommend discontinuation of somatostatin analogues prior to PRRT, recent research suggests that the uptake of PRRT may not be affected by continuous use of long-acting somatostatin analogues and both treatments could be combined safely. In a clinical prospective study, Dr. de Vries-Huizing and her co-investigator, Dr. Else Aalbersberg, will evaluate whether treatment with long-acting somatostatin analogues with PRRT does not negatively affect the PRRT radiation dose. The combination of both therapies could also lead to a reduction of the radiation dose delivered to healthy tissues. Also, continuous use of long-acting somatostatin analogues could prevent an increase in functional NET symptoms like flushing and diarrhea.

Why is this important?

Halting long-acting somatostatin analogues prior to PRRT can be challenging for patients and treatment logistics. Discontinuation could also increase functional NET symptoms like diarrhea and flushing. As an alternative, patients can switch to short-acting somatostatin analogues but these require multiple daily injections. The burden for patients would therefore be much less if long-acting somatostatin analogues could be continued during PRRT.

What will the researchers do?

The investigators will perform a clinical trial in which patients receive long-acting lanreotide, octreotide or no somatostatin analogue on set days prior to PRRT. They will compare the radiation dose delivered to tumors and healthy tissues between these groups and evaluate the quality of life in the different treatment groups.

How might this improve treatment of NETs?

Combining long-acting somatostatin analogues might improve the therapeutic window in PRRT by increasing the radiation dose to tumors and reducing the dose to healthy tissue, thereby improving treatment outcomes with less toxicity. This approach may also obliterate the need for switching between long-acting and short-acting somatostatin analogues prior to each cycle of PRRT.

What is the next step?

The next step for the investigators is to apply for ethical approval for the clinical trial and work toward including the first patient.

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