In patients with gastroenteropancreatic neuroendocrine tumors, first-line administration of radioligand therapy reduces the risk of disease progression or death. This is what emerges from a phase III study (NETTER-2) presented during the American Society of Clinical Oncology Gastrointestinal Cancers Symposium 2024. The radioligand is composed of two elements: a radioactive particle that releases therapeutic radiation that affects tumor cells, causing their death, and a ligand, also called “carrier”, i.e. a molecule capable of recognizing and binding to tumor cells.
The study was conducted in patients with advanced, well-differentiated, grade 2/3, somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. In this group of patients, treatment with 177lutetium oxodotreotide in addition to prolonged-release octreotide reduced the risk of disease progression or death by 72% compared to octreotide alone. In particular, disease progression-free survival increased to 22.8 months compared to 8.5 months in patients treated with octreotide alone.
“This innovative approach not only improves patients’ progression-free survival and clinical response, but is well tolerated, also allowing for an excellent quality of life for patients”, says Salvatore Tafuto, director of the Sarcoma and Rare Tumors Complex Facility. ‘lrccs Pascale National Cancer Institute of Naples and coordinator of the NETTER-2 study at national level. “Many patients continued their work and relationship lives without problems, with little short-term side effects.”
“Radioligand therapy acts like internal radiotherapy aimed at the tumor. Specifically, it makes use of the combined action of a ligand, which specifically recognizes and binds to the receptors expressed on neoplastic cells, and a radioisotope, which carries out the action therapeutic, releasing radiation”, explains Secondo Lastoria, director of the Complex Structure of Nuclear Medicine and Metabolic Radiotherapy at Pascale. “This approach can be considered an important paradigm of personalized medicine.”
Prostate and kidney cancers, further progress in therapy
The results of two clinical trials confirming the benefits of treatment with the drug cabozantinib in association with immunotherapy in the treatment of prostate cancer and renal cell carcinoma will be presented at the American Society of Clinical Oncology Genitourinary Symposium in San Francisco.
The phase III CONTACT-02 study demonstrated the superiority, in terms of disease progression-free survival, of the combination of cabozantinib and atezolizumab compared to treatment with a second new generation hormone therapy in patients with metastatic prostate cancer resistant to castration where the disease has progressed after previous hormone therapy. Improvements were also observed in overall survival, however these data are still immature and the study will continue further.
Four-year data from the phase III CheckMate -9ER study in patients with previously untreated advanced renal cell carcinoma will also be presented during the meeting. After a follow-up of nearly 5 years, the combination of cabozantinib and nivolumab produced a 10-month gain in overall survival compared to treatment with sunitinib (46.5 months versus 36 months). Furthermore, progression-free survival almost doubled from 8.4 months for sunitinib alone to 16.4 months for the cabozantinib and nivolumab combination.
“Our study data continues to support the value of cabozantinib for patients with challenging tumors,” says Christelle Huguet, EVP and Head of Research and Development, Ipsen. “In combination with immunotherapy, cabozantinib is now providing long-term survival benefits to renal cell carcinoma patients worldwide, while demonstrating its future potential in metastatic castration-resistant prostate cancer.”
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