Endocrine Abstracts

Personalized (precision) medicine has already made its mark and has the potential to enhance patient management. It consists in adapting healthcare strategies tailored to individual and disease characteristics. Nuclear medicine has a central role in personalized medicine via theranostics approaches. PRRT is now a well established treatment option for well-differentiated advanced neuroendocrine tumors (NETs). PRRT is based on the administration of somatostatin analogs (SSA) labeled with a therapeutic isotope (e.g. ¹⁷⁷Lu, ⁹⁰Yttrium (⁹⁰Y)). Before PRRT, assessment of in vivo SSTR expression is mandatory and is based on the use of a companion diagnostic agent corresponding to a SSA labeled with ⁶⁸Ga, which is now preferred for molecular imaging of NET. Beyond SSTR expression, several important factors need to be considered for determining whether an individual patient is likely to benefit from PRRT (e.g., age, general condition, tumor grade, SSTR expression profile... ). In metastatic insulinomas, PRRT may be recommended as a second-line therapy after failure of diazoxide to control hypoglycemia. PRRT can also be considered in some grade 3 NETs. Overall, toxicity is limited, especially when using ¹⁷⁷Lu due to its lower tissue penetration range compared with ⁹⁰Y but needs to be monitor especially for hematological (bone marrow) toxicities.