Optimising Radioligand Therapy for Patients with Gastro-Entero-Pancreatic Neuroendocrine Tumours: Expert Opinion from an Italian Multidisciplinary Group.

Autor: Fazio N; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, Istituto Europeo di Oncologia (IEO) IRCCS, Milan, Italy., Falconi M; Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy., Foglia E; School of Industrial Engineering and HD LAB-Carlo Cattaneo-LIUC University, Castellanza, Italy., Bartolomei M; Nuclear Medicine Unit, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy., Berruti A; Medical Oncology Unit, ASST Spedali Civili, Brescia, Italy.; Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia, Brescia, Italy., D'Onofrio M; Radiology, GB Rossi University Hospital, University of Verona, Verona, Italy., Ferone D; Endocrinology, Department of Internal Medicine and Medical Specialties (DiMI), University of Genova and Endocrinology Clinic, IRCCS, Ospedale Policlinico San Martino, Genoa, Italy., Giordano A; Nuclear Medicine Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.; Section of Nuclear Medicine, Dipartimento Universitario di Scienze Radiologiche ed Ematologia, Università Cattolica del Sacro Cuore, Rome, Italy., Grimaldi F; Endocrinology and Diseases of Metabolism Unit, University Hospital Santa Maria Misericordia, Udine, Italy., Milione M; Anatomia Patologica 1, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Panzuto F; Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University and Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy., Santimaria M; Nuclear Medicine Unit, S. Bortolo Hospital, AULSS 8 Berica, Vicenza, Italy., Schillaci O; Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy., Seregni E; Nuclear Medicine Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Stasi M; Medical Physics Department, A.O. Ordine Mauriziano di Torino, Turin, Italy., Volante M; Department of Oncology, University of Turin, and Pathology Unit, San Luigi Hospital, Turin, Orbassano, Italy., Lastoria S; Nuclear Medicine and Therapy with Radionuclides, Cyclotron and Radiopharmacy Units, IRCCS National Cancer Institute, Fondazione Senatore G. Pascale, Via M. Semmola, 80131, Naples, Italy. s.lastoria@istitutotumori.na.it.
Jazyk: angličtina
Zdroj: Advances in therapy [Adv Ther] 2024 Jan; Vol. 41 (1), pp. 113-129. Date of Electronic Publication: 2023 Nov 21.
DOI: 10.1007/s12325-023-02714-8
Abstrakt: Radioligand therapy (RLT) with lutetium ( 177 Lu) oxodotreotide is an approved therapy in combination with somatostatin analogues (SSAs) for patients with advanced, well-differentiated G1-G2, gastro-entero-pancreatic neuroendocrine tumours (GEP-NETs) that progress on SSAs. We conducted a series of round table meetings throughout Italy to identify issues related to RLT delivery to patients with GEP-NETs. Four key issues were identified: (1) the proper definition of tumour progression prior to RLT initiation; (2) the impact of RLT in patients with bone metastases and/or high hepatic tumour burden; (3) the optimal follow-up protocol after RLT; and (4) organisational issues related to RLT use and managerial implications. This article reviews the literature relating to the aforementioned issues and makes recommendations based on available evidence and Italian NET experts' opinions. In particular, the group recommends the development of a diagnostic-therapeutic care pathway (DTCP) for patients undergoing RLT which provides systematic guidance but can still be individualised for each patient's clinical and psychosocial needs. A DTCP may clarify the diagnostic, therapeutic and post-treatment monitoring process, and improve communication and the coordination of care between hub and spoke centres. The DTCP may also contribute to changes in the care process related to the 2013/59/EURATOM Directive and to the definition of costs when planning for future or updated reimbursement of RLT in Italy.
(© 2023. The Author(s).)
Databáze: MEDLINE
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