A study presented at the 2016 Society of Nuclear Medicine and Molecular Imaging Annual Meeting (June 11-15; San Diego, CA [SNMMI]) has found that a novel investigative blood test could predict how patients with malignant neuroendocrine tumors (NETs) respond to peptide receptor radionuclide therapy before committing to a treatment course.
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NETs are a rare form of cancer that develop where hormone signaling occurs between nerve cells and organs of the endocrine system, most commonly in the gastrointestinal tract, the lungs, or the pancreas. Often, the disease is not diagnosed until after it has metastasized, but injection with peptide receptor radionuclide therapy has been found to lower systemic side effects in some patients. For that reason, researchers have often looked at ways to better identify patients most likely to respond to the drug.
At SNMMI 2016, researchers presented the results of a genetic blood test called NETest®, which measures the specific NET genes circulating in the blood that are believed to predict responsiveness to peptide receptor radionuclide therapy.
For the study, they evaluated 72 NETs being treated with peptide receptor radionuclide therapy over the course of 33 months. Participants underwent standard imaging and histological evaluations in addition to the receipt of the NETest.
Results showed that peptide receptor radionuclide therapy led to a 68% rate of overall disease control and a median progression-free survival that was not yet achieved by the end of follow-up. Additionally, about three-fourths (73%) of low-grade tumors responded to treatment along with half (50%) of high-grade tumors.
Further, compared with somatostatin receptor imaging—a common method of imaging for NETs—NETest was better able to evaluate and predict therapy response and nonresponse. Indeed, the predictive response index of select NETest genes associated with metabolism signaling, and grade was found to be more than 90% accurate.
The results of the study could help physicians provide a more personalized approach to their care by identifying the specific patients most likely to benefit from peptide receptor radionuclide, the researchers concluded.
"Using this method, a patient would be able to know if [peptide receptor radionuclide therapy] would be an effective cancer therapy for them," said lead author of the study Lisa Bodei, MD, PhD, European Institute of Oncology (Milan, Italy). "Additionally, further blood tests could be used to monitor the progress of treatment, rather than relying on statistics that are not specific to them as individuals."
