Dr. Paulson on When to Consider Lutathera in Patients With NETs
Scott Paulson, MD
Scott Paulson, MD, co-director of the Gastrointestinal Research Program for The US Oncology Network, medical director for the Neuroendocrine Research and Treatment Center at Baylor Charles A. Sammons Cancer Center, Baylor University Medical Center, discusses when to consider using Lutathera (lutetium Lu 177 dotatate) in patients with neuroendocrine tumors (NETs).
In January 2018, the FDA approved Lutathera for the treatment of patients with somatostatin receptor–positive gastroenteropancreatic NETs. Physicians should consider using the agent when patients have had some degree of progression or evidence of tumor growth on a somatostatin analog like lanreotide (Somatuline Depot) or octreotide LAR, says Paulson. Lutathera should not be considered as frontline therapy, explains Paulson, except in rare cases. It also should not be reserved as a last resort. Its optimal placement probably resides in the middle of treatment, says Paulson.
Although Lutathera is an approved novel therapy, there are challenges with its use in practice. It is a difficult medication to get access to, and it is not easy to administer. Additionally, because it is such a new therapy, providers are unsure where to sequence it in a patient’s course of treatment.