Wearable Technology to Personalize Lu-177-DOTATATE Therapy for NETs

Researchers at the University of Washington in Seattle, Washington, are developing a user-friendly (worn at home) vest with technology that collects data to tailor personalized therapy for patients with metastatic, somatostatin-receptor-2 positive neuroendocrine tumors (NETs). The study was presented at the 2019 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI).

Targeted therapy using lutetium-177 (177Lu)-DOTATATE greatly increases progression-free survival for NETs patients. While approved by the United States Food and Drug Administration (FDA), the FDA package instructions call for patients to receive a standardized protocol, regardless of size or weight. Traditionally, targeted radionuclide therapies are personalized based on dose to the main organs at risk (OAR, e.g., kidneys, liver, spleen).

"Organ specific dosimetry for the 177Lu-DOTATATE (Lutathera) is the norm at many medical centers outside of the United States," explains Robert Miyaoka at the University of Washington. "Longitudinal imaging studies are conducted after each therapy treatment to determine the cumulative dose to the OAR for each patient. The standardized 177Lu-DOTATATE treatment protocol in the United States consists of four 200 mCi doses spaced two months apart. Although this is safe for a vast majority of patients, it is less than optimal for most. Studies out of Europe are revealing that tailoring the number of treatment doses based upon the dose-limiting toxicity to the patient's OAR can more than double the progression-free and overall survival for NET patients undergoing 177Lu-DOTATATE therapy."

Another factor the researchers sought to address is the fact that traditional imaging-based methods for organ dosimetry estimation for 177Lu require three-to-four longitudinal imaging sessions spread over seven days. This is expensive, uses a lot of clinic resources and is burdensome to the patient.

"We propose to create a lightweight, low-cost, wearable, patient-specific technology that will allow organ-specific measurement recordings to be made within the comfort of the patient's home," Miyaoka says. "The garment [called a multi-detector personalized home dosimetry (MD PHD) vest] will house 15-20 small radiation detectors, strategically placed within the vest based upon the patient's own anatomy. In addition to the radiation detectors the vest will be coupled to a compact electronics pack that will acquire the data and send it via WiFi or cellular services to a secure website where medical personnel/software can check the data for quality control in near real-time."

He further explains, "The patient will be asked to wear the vest for a two-minute data acquisition once a day for seven (and up to 21) days. Based upon these at-home measurements and a single SPECT/CT image taken 24 hours after the therapy administration, organ specific dosimetry will be determined for all of the patient's OAR." With the information collected via the vest, physicians would be able to tailor the number of treatments based upon personalized organ dosimetry information.

Miyaoka reports, "Preliminary vest results from simulations are showing that at-home vest measurements made over 7-21 days can provide organ-specific washout rates with precision as good or better than the current accepted gold standard of three-four quantitative SPECT/CT images acquired over seven days. The initial goal of this technology is to enable personalized 177Lu-DOTATATE therapies in the United States and to lower the cost for treatment personalization throughout the world."

Abstract 313: "Wearable Technology to Enable Personalization of Lu177-DOTATATE Therapy for Neuroendocrine Tumor Patients," Robert Miyaoka, Larry Pierce, Robert Harrison and Hubert Vesselle, University of Washington, Seattle, WA. SNMMI's 66TH Annual Meeting, June 22-25, 2019, Anaheim, CA.

All 2019 SNMMI Annual Meeting abstracts can be found online at http://jnm.snmjournals.org/content/60/supplement_1.

About the Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine and molecular imaging, vital elements of precision medicine that allow diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes.

SNMMI's more than 16,000 members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice.

Most Popular Now

Sanofi and Google to Develop New Healthc…

Sanofi and Google will establish a new virtual Innovation Lab with the ambition to radically transform how future medicines and health services are delivered by tapping into the power of...

From One Brain Scan, more Information fo…

MIT researchers have devised a novel method to glean more information from images used to train machine-learning models, including those that can analyze medical scans to help diagnose and treat...

A Miniature Robot that could Check Colon…

Engineers have shown it is technically possible to guide a tiny robotic capsule inside the colon to take micro-ultrasound images. Known as a Sonopill, the device could one day replace...

Your Circle of Friends, not Your Fitbit…

Wearable fitness trackers have made it all too easy for us to make assumptions about our health. We may look to our heart rate to determine whether we really felt...

Call for Startup Pitch Day @ Villeroy …

The Startup Pitch Day is a competition to identify innovative Startups with the aim of creating potential cooperation with Villeroy & Boch Innovations GmbH. Therefore 10 startups are invited to...

Cognitive Behavioral Therapy Delivered b…

Preliminary findings from two analyses of an ongoing study suggest that cognitive behavioral therapy for insomnia delivered by telemedicine is as effective as face-to-face delivery. Results of a randomized controlled...

IMS MAXIMS Forms e-Prescribing Partnersh…

IMS MAXIMS has formed a partnership with Better by Marand to become a reseller for its e-prescribing system, OPENeP. The move gives NHS trusts that want to progress their digital...

Oxford Health Uses Oxehealth Technology …

Oxford Health NHS Foundation Trust has introduced a new observation protocol for checking the safety of patients with severe mental health conditions at night, after a formal evaluation of technology...

Wearable Technology to Personalize Lu-17…

Researchers at the University of Washington in Seattle, Washington, are developing a user-friendly (worn at home) vest with technology that collects data to tailor personalized therapy for patients with metastatic...

QUIBIM to Develop Platform in Leading Re…

QUIBIM is helping to advance knowledge of the most lethal pediatric tumors through EU-funded project PRIMAGE, which exploits precision information from medical imaging to establish tumor prognosis, and expected treatment...

3D Body Mapping could Identify, Treat Or…

Medical advancements can come at a physical cost. Often following diagnosis and treatment for cancer and other diseases, patients' organs and cells can remain healed but damaged from the medical...