Peptide Receptor Radionuclide Therapy (PRRT) is a promising second-line treatment for patients with neuroendocrine tumours. Currently, PRRT is delivered as a one-size-fits-all dose protocol, and although offering significant improvements to patient quality of life, it largely remains a palliative treatment. In order to progress PRRT such as 177Lu-DOTATATE into a treatment with curative intent, one strategy is to increase the injected radionuclide dose. Yet to justify any increase in radioactivity and risk additional normal toxicity, a suitable metric is needed to determine the required 177Lu dose for each tumour within a patient.
I have recently demonstrated the ability to image the DNA double strand break marker yH2AX generated in response to 177Lu-DOTATATE therapy in pre-clinical models. I am currently determining if this imaging technique will enable a predictive metric for therapeutic success. By using a metric such as this, a truly adaptive dose regimen could be offered to patients to tailor the radionuclide dose to each patient's tumour with curative intent and minimise any excess normal tissue toxicity.
O'Neill E. et al, (2019), J Nucl Med
Imaging DNA Damage in vivo following [Lu-177] Lu-DOTATATE therapy in a model of pancreatic neuroendocrine cancer
O'Neill E. et al, (2019), EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 46, S196 - S196