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PRRT – Novel Molecular Targeted Therapy for NETs

PRRT – Novel Molecular Targeted Therapy

Peptide Receptor Radionuclide Therapy (PRRT) is a type of nuclear medicine therapy used to treat neuroendocrine tumors, also called NETs. PRRT is a part of theranostics, a progressive field of precision medicine that employs a personalized, patient-centric approach. The primary goal of PRRT is to alleviate symptoms, slow or stop tumor progression, and to improve overall survival. PRRT has been in use in Europe in the last decade, and it is generally well-tolerated. At Sheba Medical Center, this therapy is administered by specialists at The Institute of Endocrinology.

PRRT page

How does PRRT Targeted Therapy work?

The cell surfaces of NETs usually express receptors for somatostatin, a hormone secreted naturally in the body. PRRT uses compounds that imitate this hormone, called somatostatin analogues (SSAs), to treat patients with NET. A radioactive compound, Lu-177, is attached to SSAs to create radiopeptides that are injected into the patient’s vein. The radiopeptides then bind to the somatostatin receptors on the neuroendocrine tumor cells, and the radioactive material is absorbed into the tumor. Irradiation is therefore targeted, delivering a high dose directly to the cancer cells.

PRRT is performed by injecting the radiopeptides into the patient’s bloodstream. This is a systemic therapy that can reach all parts of the body. However, because the radiopeptides are tailored to target and damage the unique molecular properties of neuroendocrine tumor cells, the radiation exposure to healthy tissue is limited. Administration of the drug and other required medications takes approximately 4-5 hours, but patients typically remain in the hospital for about two days for preparation and evaluation after the treatment.

What conditions can be treated with PRRT?

PRRT is used to treat advanced or metastatic NETs, particularly tumors that originate in the lungs, stomach, intestine or pancreas (also referred to as carcinoid or islet cell carcinomas). While NETs are generally rare, they are usually diagnosed at a late, progressive stage. PRRT is FDA-approved and indicated for patients with gastro-entero-pancreatic NETs.

What are the possible side effects of PRRT Targeted Therapy ?

Every individual reacts differently to PRRT, but some adverse side effects may occur.

The most typical side effects include:

  • Abdominal discomfort or pain
  • Nausea
  • Vomiting
  • Diarrhea
  • Anemia
  • Low counts of white blood cells and platelets
  • Fatigue

Although extremely rare, some patients experience temporary hair loss or subacute hematological toxicity.

Who is a candidate for PRRT?

PRRT Targeted Therapy may be a suitable option for the following types of patients:

At present, children and patients with chronic kidney failure are not candidates for PRRT, because there is insufficient data on its use for these conditions.

Why choose Sheba for PRRT in Israel?

The staff of Sheba’s Institute of Endocrinology, the department in which PRRT is delivered, comprises top specialists who have undergone training at premier medical centers around the world. In addition, as the largest hospital in the region, Sheba treats more patients with NETs, a relatively rare disease, than many other cancer centers – and more experience translates into more successful outcomes.

At Sheba, we are dedicated to custom-tailoring medicine to treat each patient’s unique condition. After assessing each case and getting to know the patient, our doctors design a treatment program that considers the individual’s needs. The administration of PRRT, a targeted therapy, is in perfect alignment with our personalized approach to healthcare in general and cancer therapy specifically.

The price of PRRT in Israel is significantly lower than it is in the United States, with no need to compromise on the quality of your medical care. As a government institution, our costs are fully transparent. The price for PRRT is all-inclusive, with no additional fees for associated health services (such as amino acids to protect the kidneys).

To create an efficient and reassuring experience for every patient, a personal coordinator from the Global patient services is assigned to assist throughout the entire treatment process at Sheba. From travel arrangements to language translations to follow-up care, constant assistance is provided. Also, if we have all the relevant scans and blood tests ready, PRRT can be coordinated and delivered on the same day of your arrival at Sheba.

Meet the Department Manager

Amit Tirosh

Dr. Amit Tirosh

Dr. Amit Tirosh is the Head of the Neuroendocrine Tumors Service at the Institute of Endocrinology, and he specializes in inherited syndromes related to the development of neuroendocrine tumors. He is actively researching the bioinformatics of endocrine cancer, particularly neuroendocrine tumors, and he collaborates with research groups around the globe. Dr. Tirosh provides patients suffering from NETs with state-of-the-art medical therapies, and he lectures regularly on this topic to medical students at the Sackler Faculty of Medicine, Tel Aviv University. He is also a member of the National Institutes of Health in the US in the field of MEN1 syndrome and a respected member of a team of international experts on VHL.
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