PRRT (PART II)

More about PRRT

Peptide Receptor Radionuclide Therapy

Original post April 24, 2019; Updated 12/17/2022

In our previous article, “These Four Letters: PRRT, An Overview of PRRT”, we gave an overview on PRRT including a discussion of theranostics and the importance of the Ga-68 scan in determining if a patient is a candidate for PRRT. This article will answer more frequently asked questions and provide links to helpful videos, articles, and patient resources.

What is the difference between PRRT, Lu-177 and Lutathera®?

NET patients in the United States may see these terms used interchangeably:

PRRT

Lutetium 177 Dotatate

Lu-177

Lutathera® (the brand name for the FDA approved drug)

SSTR Therapy

• PRRT is a class of radioactive drugs that uses a targeting molecule bound to a radiation component.

• There are other types of PRRT currently being developed that may be available only under clinical trials or in Europe.

• Lutetium-177 (Lu-177) is a radioisotope used for targeted therapy. Lu177 is linked to a protein, forming Lutetium-177 dotatate, to target the same receptors as Ga-68, Cu-68, lanreotide, and octreotide.

• Lutathera® is the brand name of radioactive drug or radiopharmaceutical, lutetium-177 (Lu-177) dotatate that is manufactured by Advanced Accelerator Applications (AAA). Lutathera® is the first in the class of PRRT drugs currently approved by the FDA and available for use in the United States.

• SSTR therapy is another term for PRRT since it targets the somatostatin receptors.

*Note: There are many other “keys” in development, which means hope for future options in NET treatment.

Who might be a candidate for PRRT?

According to the FDA Approval found here, PRRT is indicated for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults.

1. Adults (who are not pregnant) with gastorenteropancreatic neuroendocrine tumors. This includes NET in the pancreas or GI tract (stomach, intestines, colon, rectum, appendix).

2. You must have a recent somatostatin imaging scan (i.e. gallium-68 PET/CT or NETSPOT®, gallium-68 PET/MRI, Cu-64 DOTATATE scan or (DETECTNET®), or octreotide scan) showing that there are somatostatin receptors present on your tumor cells.

3. Those who have advanced and/or progressive neuroendocrine tumors despite somatostatin analogues and are not a candidate for surgery.

4. Those whose symptoms have not responded to other therapies.

Where is PRRT offered?

In 2019, the Carcinoid Cancer Foundation launched a website dedicated to providing information about PRRT and the Gallium-68 PET/CT scan. This site also includes an interactive map to locate facilities where PRRT and/or the Gallium-68 PET/CT scan are being offered. Visit CCF’s website here.

How can I learn more about PRRT?

WATCH:

• Watch the LACNETS PRRT videos here

READ:

• 2019 NANETS/SNMMI Procedure Standard for Somatostatin Receptor Based Peptide Receptor Radionuclide Therapy with 177Lu-Dotatate

• 2020 NANETS/SNMMI Consensus Statement on Patient Selection and Appropriate Use of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy

• First PRRT Approved by U.S. Food and Drug Administration, NETRF

• What is Peptide Receptor Radionuclide Therapy (PRRT)? NETRF

• Improving PRRT, NETRF

• SNMMI PRRT fact sheet

• PRRT is now in the NCCN Guidelines for Patients: Neuroendocrine Tumors and the NCCN Clinical Practice Guidelines in Oncology (for healthcare professionals): Neuroendocrine and Adrenal Tumors.

Check out these helpful patient education materials from Advanced Accelerator Applications:

	“Your Guide to NETSPOT®”addresses frequently asked questions and important safety information about the Ga-68 scan.
	​The patient brochure: “Your Guide to Lutathera Treatment” answers many frequently asked questions including how Lutathera® is given, what to expect following treatment, and important safety information. It also provides information about AAA PatientCONNECT, a patient assistance program.
	​The “Quick Look at Lutathera®” brochure provides some basic information as well as important safety information.
	​AAA PatientCONNECT is a patient support program including financial assistance and reimbursement support services.
	​“A Journey of Hope,” describes the journeys of five NET patients and their experiences with PRRT.

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Written by Lisa Yen, NP, NBC-HWC

Director of Programs & Outreach, LACNETS