Edward O'Neill

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.