Patients with metastatic neuroendocrine cancer no longer have to travel abroad or out of state for a sought-after targeted therapy called peptide receptor radionuclide therapy, or PRRT. Rush University Medical Center is one of the few health care providers in the United States to currently offer this therapy.
PRRT received U.S. Food and Drug Administration approval in January. Rush previously had been providing the drug to a limited number of patients as part of FDA-authorized compassionate use, and now is making PRRT available to the general population as the first site in Illinois.
PRRT has been used in Europe since the mid-1990s and has been proven to be effective for treatment of metastatic neuroendocrine cancers.
“While still relatively rare, we estimate that there are approximately 200 to 350 new cases of neuroendocrine tumors each year in Chicago,” says Dr. Xavier M. Keutgen, director of the Rush Neuroendocrine Tumor Program. “This therapy, which has only been available for a very small number of patients under compassionate use, is now available to all NET patients. It has the potential to revolutionize care for those with advanced neuroendocrine tumors.”
PRRT targets cancer cells, leave healthy cells unharmed
Neuroendocrine tumors develop from neuroendocrine cells, a complex network of cells that release hormones that help regulate various biological functions. Because these cells are found throughout the body, neuroendocrine tumors can grow in many different places, including the pancreas, adrenal glands, gastrointestinal tract, lungs and brain. Prognosis and treatment recommendations for neuroendocrine tumors tend to vary depending on the tumor’s origin, stage and grade.
Patients receiving PRRT are injected with a special radiopharmaceutical, which consists of a synthetic hormone called octreotide along with a small amount of radioactive material. This drug travels through the bloodstream, delivering doses of radiation to any neuroendocrine tumor cells encountered while leaving healthy cells unharmed.
“Neuroendocrine tumor cells are unique in that they have somatostatin receptors on their cell surface, and PRRT only targets these somatostatin receptors,” Keutgen says. Since octreotide mimics somatostatin (a growth-inhibiting hormone), it causes PRRT to bind with the neuroendocrine tumor cells’ somatostatin receptors.
Comprehensive care team, advanced diagnostic technology
PRRT treatment adds to Rush’s already advanced care for patients with neuroendocrine tumors. Keutgen organized a team of experts at Rush that includes surgeons, interventional radiologists, medical oncologists, endocrinologists, gastroenterologists, pathologists and other subspecialists that in 2016 launched the very successful Rush neuroendocrine tumor program, the first and only program of its kind in the Chicago area. Together, they offer the most advanced diagnostic as well as medical and surgical treatment modalities for patients with neuroendocrine tumors.
“Patients need a team of experts who know all the available options and can determine the best approach for a particular patient with a particular type of tumor,” Keutgen said.
In 2017, Rush became the first hospital in Illinois to offer the most sensitive diagnostic test for neuroendocrine tumors. The 68 Gallium DOTATATE PET/CT scanner is a sophisticated functional imaging test that allow experts at Rush to pinpoint tumor location with more than 90 percent accuracy.