Innovative Combination Therapy Shows Promise for Neuroendocrine Tumor Treatment

A novel combination therapy that integrates a radiopharmaceutical, 177Lu-DOTATATE, with a DNA-repair inhibitor, olaparib, has demonstrated safety and feasibility for patients with neuroendocrine tumors. This approach aims to enhance treatment outcomes by preventing cancer cells from repairing radiation-induced damage, potentially leading to more sustained disease control. The findings were published in the latest edition of The Journal of Nuclear Medicine.

177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) has been a cornerstone treatment for patients diagnosed with low- to intermediate-grade metastatic neuroendocrine tumors. Although this targeted therapy can yield long-lasting results--sometimes extending for years--most patients ultimately encounter disease progression.

Research has indicated that inhibiting poly(adenosine diphosphate-ribose) polymerase (PARP) could significantly enhance the efficacy of PRRT. Researchers embarked on a clinical study to evaluate this combination treatment.

The study involved 18 patients who received 177Lu-DOTATATE PRRT followed by varying doses of olaparib (50-300 mg administered twice a day) over the course of up to four treatment cycles. The study meticulously tracked toxicity levels using the National Cancer Institute Common Toxicity Criteria version 5.0, alongside monitoring progression-free survival, overall survival, response rate, and dosimetry variables.

The findings revealed that the combination therapy was generally well tolerated among participants. The primary dose-limiting toxicity observed was thrombocytopenia, which affected three patients at the highest dose of olaparib. Other reported adverse effects were mild and included low-grade bone marrow suppression, nausea, and fatigue. At the six-month follow-up, a notable 69% disease control rate was recorded.

This research underscores the potential of advancing nuclear medicine by synergizing targeted radiotherapy with pharmacological agents that augment treatment efficacy. The study's lead researcher expressed optimism that such innovative therapy combinations could expand the benefits of nuclear medicine to a broader patient population in the future.

For further details, refer to the original article titled '177Lu-DOTATATE in Combination with PARP Inhibitor Olaparib Is Feasible in Patients with Somatostatin-Positive Tumors: Results from the LuPARP Phase I Trial' published in The Journal of Nuclear Medicine.