Newswise — Illinois 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 in Chicago is one of the few health care providers in the United States, and the first in Illinois, authorized to offer this therapy for a limited number of patients prior to U.S. Food and Drug Administration approval.

PRRT has been used in Europe since the mid-90s and has been proven to be effective for treatment of metastatic neuroendocrine cancers. FDA approval for use of the drug in the U.S. is pending on the outcome of a large international, multicenter randomized clinical study evaluating PRRT’s effectiveness.

“While still relatively rare, 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 in other countries until now, 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 explains. 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 last year launched Rush’s neuroendocrine tumor program, the only program of its kind in the Chicago area. Together, they offer the most advanced diagnostic and treatment modalities available 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.  

Earlier this year, 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, compared with the 30 to 70 percent accuracy of an octreotide scan, the next-most-sensitive test. This ability is particularly useful for patients with neuroendocrine tumors of unknown primary origin, who make up about 15 to 20 percent of neuroendocrine tumor patients.