Gastroenteropancreatic neuroendocrine tumors (NETs) are a rare type of cancer that originates from hormone-producing cells in the digestive system, including the stomach, intestines, and pancreas.
A groundbreaking study, NETTER-2, has shown promising results for patients with advanced gastroenteropancreatic NETs, marking the first time radioligand therapy (RLT) has been tested as a first-line treatment for any cancer population. This study also represents the first randomized trial for patients with advanced gastroenteropancreatic NETs, offering new hope for those who previously had limited treatment options.
The study was led by Dr. Simron Singh, an associate professor in the Temerty Faculty of Medicine at the University of Toronto, and the findings were published in The Lancet.
Traditional radiation therapy involves directing high-energy radiation beams at the tumour from outside the body. While effective, it can impact nearby healthy tissues and organs, leading to potential side effects.
In contrast, radioligand therapy combines targeted radiation with molecular therapy to fight cancer. This approach uses radioactive substances (radioligands) that specifically bind to cancer cells, delivering high doses of radiation directly to the tumour while sparing surrounding healthy tissue.
The radioligands are designed to attach to certain receptors or molecules on the cancer cells ensuring precise targeting. Once bound, the radioactive component emits radiation that destroys the cancer cells from within, making radioligand therapy a promising option for treating various types of cancers, especially those with limited treatment options.
This novel treatment showed a striking extension of survival, from 8.5 months in the control group to 22.8 months in the treatment group: a 14-month extension in progression-free survival. Moreover, no new safety concerns were observed. Importantly, the study found no significant difference in quality of life between the treatment groups, indicating that adding radioligand therapy did not negatively affect patients’ overall well-being compared to the generally well-tolerated somatostatin analogue therapy.
Before this study, treatment options for higher-grade gastroenteropancreatic NETs were limited and often ineffective. Existing therapies, including chemotherapy, had shown only modest benefits. The NETTER-2 study offers a significant advancement, providing robust data to support better treatment decisions.
The implications of NETTER-2 are far-reaching. Until now, no randomized studies had investigated first-line radioligand therapy for any solid tumour, making these findings a pivotal step forward. Early molecular imaging and radioligand therapy could revolutionize treatment for cancer patients.
