417P - Availability and Utility of Functional Imaging (FI) and Peptide Receptor Radionuclide Therapy (PRRT) in the CommNETS Collaboration (Australia, Cana...

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Neuroendocrine Cancers
Imaging, Diagnosis and Staging
Surgery and/or Radiotherapy of Cancer
Presenter Bryan Chan
Citation Annals of Oncology (2016) 27 (suppl_9): ix130-ix131. 10.1093/annonc/mdw590
Authors B.A. Chan1, H. Sim1, A. Ravikumar2, D. Bailey3, D. Chan4, B. Lawrence5, A. McEwan6, N. Pavlakis7, E. Segelov8, S. Singh4, P. Roach9, D. Wyld10
  • 1Department Of Medical Oncology And Hematology, Princess Margaret Hospital, M5G 2M9 - Toronto/CA
  • 2Department Of Nuclear Medicine, Peter MacCallum Cancer Center, VIC 3000 - Melbourne/AU
  • 3Department Of Nuclear Medicine, Royal North Shore Hospital, NSW 2065 - St Leonards/AU
  • 4Department Of Medical Oncology, Sunnybrook Odette Cancer Center, Sunnybrook HSC, M4N 3M5 - Toronto/CA
  • 5Department Of Medical Oncology, Auckland City Hospital, Auckland 1023 - Auckland/NZ
  • 6Department Of Oncology, University of Alberta Cross Cancer Institute, T6G 1Z2 - Edmonton/CA
  • 7Medical Oncology, Royal North Shore Hospital, 2065 - St Leonards/AU
  • 8St Vincent's Clinical School, University of New South Wales, 2010 - Sydney/AU
  • 9North Shore Radiology & Nuclear Medicine, North Shore Private Hospital, NSW 2065 - St Leonards/AU
  • 10Department Of Medical Oncology, Royal Brisbane and Women's Hospital, 4006 - Herston/AU

Abstract

Background

The use of FI and PRRT is integral to the management of neuroendocrine tumors (NETs). Considerable global variability exists in access to and utility of FI and PRRT.

Methods

A survey of PRRT centres within CommNETS was conducted to explore the use of FI and PRRT. Two companion surveys were completed by the lead in nuclear medicine and medical oncology per site. Descriptive and inferential statistical methods including nonparametric analyses were performed to evaluate differences in accessibility and availability, models of care, protocols and funding.

Results

16 surveys were sent to the 8 PRRT centres across CommNETS (Aust: 6, Canada: 2, NZ: 0). Response rate was 100%. All were academic centres reviewing 110 new and 140 followup patients per month. All centres had access to Octreotide scans, but in Australia this has been superseded by tandem Gallium68 (Ga) and 18Fluorine (FDG) positron emission tomography (PET) scans to stage and assess biology and heterogeneity of NETs. GaPET scans were not available in Canada. Although FDGPET was unfunded for NETs within CommNETS, it was routinely ordered (63%) for grade 2 or 3 NETs. To assess response, 63% used GaPET scans at 6month intervals and 38% ordered both Ga and FDGPET scans. PRRT was only available on clinical trial in Canada. Lutetium177 was the standard PRRT isotope at all centres for most indications. Radiosensitising chemotherapy was used in 5 centres (not in Canada) capecitabine (45%) or capecitabine and temozolomide (36%). Four cycles of PRRT was universal but intervals varied between every 8 weeks (50%), 6 weeks (25%) or 10 weeks (25%), usually without maintenance therapy (63%). Considerable variation existed regarding concurrent somatostatin analogue usage, determination of renal function, dosimetry, dose adjustments and minimum haematological parameters. Only five sites recorded quality of life outcomes.

Conclusions

This is the first survey to assess the availability and utility of FI and PRRT within CommNETS. Future collaborative efforts will try to improve access and share knowledge between experienced and upcoming PRRT centres to develop standard operating procedures and cooperative trials.

Clinical trial indentification

Legal entity responsible for the study

CommNETs Collaboration

Funding

CommNETs Collaboration

Disclosure

All authors have declared no conflicts of interest.