Lu-177 DOTATATE therapy for progressive metastatic neuroendocrine tumors: Multidisciplinary team work and role of technologists, nurses, physicists and physicians.

Objectives: reatment of metastatic neuroendocrine tumors is multidisciplinary and generally involves surgery, radiation, chemotherapy, and somatostatin analog therapy. A relatively newer form of treatment known as Peptide Receptor Radiotherapy (PRRT) has become increasing popular in various parts of the world for treating these tumors. One such therapy using Lutetium-177 DOTATATE (Lutathera®) has been recently approved by the FDA for its use in advanced Gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). Our institution was one of the major sites to be involved in the Expanded access /compassionate access protocol before its FDA approval. The experience of treating over 17 GEP-NET patients during the past year has helped us develop a successful working knowledge in therapy administration and post-therapy imaging protocols. Learning objectives of this educational exhibit: 1. To review the Lu177 DOTATATE workflow logistics from scheduling to therapy and post therapy imaging. 2. To review the eligibility criteria for the treatment and the bloodwork and test required for follow up of the patients. 3. To discuss in depth the multi-disciplinary team work required during the therapy administration including the nursing needs, medication requirements, monitoring during treatment, administration technique, radiation safety concerns. 4. To discuss in detail about the amino acid requirements during the therapy: comparison between the off-the-shelf amino acid solution vs the custom-made compounded amino acid solution in terms of composition, osmolality, volume, tolerability and side effects. 5. To review the future directions of PRRT therapy in terms of other disease pathologies