Dr. Philip on Adverse Events With Lutathera in NETs

Philip A. Philip, MD, PhD, FRCP, professor of medicine, Wayne State University School of Medicine, clinical professor of oncology at Barbara Ann Karmanos Cancer Institute, discusses adverse events (AEs) associated with Lutathera (lutetium Lu 177 dotatate) in neuroendocrine tumors (NETs).

Prior to the FDA approval of Lutathera, there were no systemic therapies that would lead to tumor shrinkage, says Philip. Now, approximately 20% of patients will experience tumor shrinkage with this therapy. Furthermore, many patients will achieve stable disease for a long time. In the phase III NETTER-1 trial, which served as the basis for the agent’s approval, the progression-free survival curves show a significant separation.

However, among the notable AEs observed with the peptide receptor radionuclide therapy (PRRT) is bone marrow suppression. There is also a risk of myelodysplasia or even leukemia; this can damage the kidneys. Although this damage can be counteracted by infusing amino acids, nausea and vomiting typically ensue, explains Philip. Lutathera is the first effective systemic therapy available to patients, but it does not signal the end of research regarding its use. In doing more research with regard to patient selection, sequencing, and potential combination partners, quality of life will have to be kept in mind, as most patients with NETs can lead an otherwise normal life.