By Ann Miller Baker
A first-of-its-kind cancer treatment that carries a radioactive component directly to targeted tumor cells shows promise in maintaining quality of life for patients with a rare form of intestine and colon cancer.
Few are more hopeful for positive results than Steve McBride. The 64-year old retired emergency manager for Naval Air Station Key West has struggled with abdominal pain for more than two years. A mass found through colonoscopy led to his rare diagnosis – GEP-NET, or gastroenteropancreatic neuroendocrine tumor – and a referral to Moffitt Cancer Center.
“Patients with neuroendocrine tumors (NETs) often have advanced disease that has spread to other parts of the body,” said McBride’s physician Jonathan R. Strosberg, M.D., head of Moffitt’s Neuroendocrine Tumor Program. “To date, treatment options for these cancer patients have been very limited.”
McBride’s cancer progressed while on standard therapy, an injectable drug called sandostatin. Special scans performed at Moffitt showed it spread throughout his body “like termite damage,” said McBride. That spread and the specifics of his tumor made him a perfect candidate for a new treatment called Lutathera®, approved by the Food and Drug Administration (FDA) in January for NET patients who have progressed while on somatostatin. Dr. Strosberg led the international clinical trials critical to its FDA approval and Moffitt became one of the first U.S. cancer centers to offer the treatment commercially.
Lutathera is a novel treatment known as peptide receptor radionuclide therapy. It consists of a radioactive isotope attached to a molecule that will bind to a receptor on NET cancer cells. Once given to patients intravenously, it delivers a high dose of targeted radiation to the cancer.
So far, McBride has had one Lutathera infusion at Moffitt, under the watchful care of Ghassan El-Haddad, M.D., who leads Moffitt’s Radionuclide Therapy Program. McBride was especially grateful for the time taken by Dr. El-Haddad and nurse practitioner Johnna Smith in explaining what would be involved during and after the hours-long treatment. Because patients can emit trace amounts of radiation through physical contact and bodily fluids as the therapy’s radionuclide degrades, certain precautions are necessary in the days following treatment.
With three more infusions ahead, McBride is hopeful. “So much of having cancer is waiting and having your life revolve around medical appointments,” he explained. “Being among the first to try this therapy is something tangible that I can do.”
Studies led by Dr. Strosberg show tangible evidence of Lutathera’s ability to prolong progression-free survival and to maintain patients’ quality of life. “Progression of these tumors is often associated with deterioration in quality of life due to tumor growth and production of hormones,” said Dr. Strosberg. “It is particularly important to maintain quality of life among patients with advanced NETs, given the relatively long durations of treatment and overall survival compared to other advanced malignancies.”
The latest study, published in the Journal of Clinical Oncology, demonstrated that when compared to those on standard therapy, Lutathera patients experienced a longer period of time before deterioration of quality of life measures like pain, fatigue and ability to maintain day-to-day activities.
“These data provide hope for these patients and their families,” said Dr. Strosberg.
As for McBride, he’s grateful for the opportunity to be among Lutathera’s early hopeful patients. “I’ve climbed on this bull,” he said, “and I’m going to keep riding until it bucks me off.”