Past Conventional Strategies: Enhancing Sturdiness in NETs Care with Mixed Therapy | Targeted Oncology

In an interview with Targeted Oncology on the 2025 North American Neuroendocrine Tumor Society (NANETS) Symposium, Michael Soulen, MD, mentioned the mixed remedy method for sufferers with liver-dominant neuroendocrine tumors (NETs). Soulen famous that whereas conventional liver-directed therapies like bland embolization, chemoembolization, and radioembolization have been used successfully for over 50 years, there’s a steady push to boost remedy sturdiness.

The outlined remedy protocol entails a mixture of systemic chemotherapy and peptide receptor radionuclide remedy (PRRT) utilizing Lutetium-177 dotatate. This is a novel mixture remedy, not but a standard-of-care.

The remedy schedule is very outlined: sufferers obtain an preliminary cycle of systemic chemotherapy, usually temozolomide and Cap/Tem, to make sure they will tolerate it. During the primary month, additionally they bear a simulation for PRRT, together with a DOTA-octreotate or lanreotide scan and a routine SPEC scan, to verify the security and feasibility of the renormalization process.

The mixed remedy begins within the second month. The PRRT process—dropping Lutetium-177 dotatate—is exactly scheduled for day 7 of the 14 days of chemotherapy. The aim is to maximise the tumoricidal results by probably using the chemotherapy’s sensitizing results, although the protocol is topic to modification primarily based on a affected person’s tolerability and the necessity for bone marrow restoration. The remedy is then continued for 4 complete cycles, delivered in a month-to-month or near-monthly rhythm.

The major goal is to make the present, efficient therapies stronger and long-lasting.