Jonathan Strosberg, MD, associate professor, Moffitt Cancer Center, discusses updates from the NETTER-1 study in patients with neuroendocrine tumors (NETs).

In January 2018, the FDA approved Lutathera (lutetium Lu 177 dotatate) for the treatment of patients with somatostatin receptor—positive gastroenteropancreatic NETs. This was based on findings from the phase III NETTER-1 trial, which compared Lutathera with high-dose octreotide LAR for patients with grade 1 or 2 metastatic midgut NETs.

At the 2018 ESMO Congress, a prognostic and predictive factor analysis regarding liver tumor volume was presented. Strosberg says that the liver is the primary metastatic site for patients with NETS, particularly midgut NETs. Tumor burden is known to be a poor prognostic factor, he adds. The impact of radiopharmaceuticals on liver tumor volume is not known, but it is thought that those with high tumor burden will have more liver toxicity.

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Jonathan Strosberg, MD, associate professor, Moffitt Cancer Center, discusses updates from the NETTER-1 study in patients with neuroendocrine tumors (NETs).
 

Dr. Strosberg Discusses Updates From the NETTER-1 Study

Jonathan Strosberg, MD, associate professor, Moffitt Cancer Center, discusses the FDA approval of Lutathera (177Lutetium DOTA-octreotate) as a treatment for patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

Dr. Strosberg on FDA Approval of Lutathera for GEP-NETs

Jonathan Strosberg, MD, medical oncologist, Department of Gastrointestinal Oncology, section head, Neuroendocrine Division, chair, Gastrointestinal Department Research Program, Moffitt Cancer Center, discusses quality of life in patients with midgut neuroendocrine tumors (NETs).

Patients who were enrolled in the phase III NETTER-1 trial were provided with EORTC C30 and GINET21 questionnaires to assess quality of life for both the 177Lu-Dotatate (Lutathera) arm and the high-dose octreotide (Sandostatin) arm. This preliminary analysis focused on global health quality of life, which is an important quality-of-life endpoint in any cancer, explains Strosberg.

NET-specific symptoms, such as diarrhea, flushing, and pain were also looked at. More patients on the Lutathera arm of the study had improvements in their quality of life compared with high-dose octreotide. Overall, it seems as if the quality of life has improved with Lutathera, says Strosberg.

Dr. Strosberg on Quality of Life for Midgut Neuroendocrine Tumors

Jonathan Strosberg, MD, associate professor, Moffitt Cancer Center, discusses the results of the NETTER-1 trial.

The NETTER-1 trial compared Lutathera (lutetium Lu 177 dotatate) with high-dose octreotide (Sandostatin) in patients with midgut neuroendocrine tumors (NETs). It is the first phase III prospective randomized clinical trial evaluating Lutathera in this patient population.

The primary endpoint of the trial was progression-free survival (PFS). The study demonstrated a 79% improvement in the hazard ratio for PFS. The PFS for the control arm (high-dose octreotide) was 8 months. At the time of the primary endpoint analysis, PFS had not yet been reached with Lutathera.

Results of the trial also demonstrated a 60% improvement in overall survival (OS) (

 = .004). While this result did not reach the threshold for statistical significance, it is only an interim analysis, and Strosberg remains hopeful that a final analysis of OS will see clinically and statistically significant improvement.

Jonathan Strosberg, MD

Articles

Dr. Strosberg Discusses Updates From the NETTER-1 Study

Dr. Strosberg on FDA Approval of Lutathera for GEP-NETs

Dr. Strosberg on Quality of Life for Midgut Neuroendocrine Tumors

Dr. Strosberg on the Results of the NETTER-1 Trial