2023-11-03 17:16:06
With 4 centers active in the provision of radioligand therapy (RLT) out of 34 nationally – Sant’Andrea University Hospital and Gemelli Polyclinic in Rome, Ifo and Santa Maria Goretti Hospital in Latina – Lazio is among the regions with the largest number of hospitals capable of offering an innovative oncology therapy that is revolutionizing cancer treatment starting from a rare neoplasm, such as neuroendocrine tumors (Net), but which in the future could enrich the therapeutic range of numerous types of tumors.
The Net, known for having affected people such as Fedez or Steve Jobs, “are a heterogeneous group of neoplasms with variable, sometimes silent, symptoms which make them not easily identifiable – states Francesco Panzuto, gastroenterologist at the Sapienza Aou Sant’Andrea University of Rome and president of the Italian Association for Neuroendocrine Tumors (Itanet) which will hold its overall of around 2,500 new diagnoses of neuroendocrine neoplasia every year, presumably around 200-250 in our region, of which those that arise in the digestive system (Gep-Net) represent 60-70% of cases. And just to take a photograph accurate epidemiological analysis of these patients, Itanet launched a data collection program in 2020, the Itanet Registry, unique in its kind also at an international level and now in an advanced stage of development, which to date involves 38 centers in Italy and has already included approximately 1,700 patients”.
Neuroendocrine tumors that affect the digestive system, as they are most often not associated with clear symptoms – explains a note – are often diagnosed in the metastatic phase and no longer operable (this happens in up to 40-50% of those that arise in the pancreas and in the small intestine). These patients can now benefit from an additional therapeutic option already available in Italy: radioligand therapy, a new frontier of precision medicine in the nuclear medical field, capable of ‘tagging’ and targeting tumor cells together, selectively distinguishing them from healthy ones, without damaging them. Radioligands are precision killers capable of finding the most hidden tumor cells wherever they are and destroying them one by one. It is therefore an ultra-precision target therapy, ‘tailored’ to the patient, which combines high efficacy, safety and tolerability with minimal toxicity, because it does not have to be metabolised and acts for limited periods which depend on the decay time of the radioactivity.
“The most relevant benefit of Rlt is the long-term effectiveness that it is able to offer to the patient – underlines Panzuto – With the previous therapeutic options an estimated effectiveness of 1 year-1 and a half was expected in terms of capacity to stabilize the disease. With the new approach, the expected stabilization of the disease is much longer, as demonstrated by the data from recent scientific literature which report more than 3 years of progression-free survival. Furthermore, it is well tolerated compared to other therapies which are burdened by daily toxicity, which instead in the case of Rlt is moderate and contextual to the period immediately following administration, while long-term toxicity remains very rare and today increasingly predictable”.
In Lazio – continues the note – the level of assistance and care for Net patients has clearly improved in recent years, above all thanks to the presence of reference centers and the arrival of the Rlt which, by its nature, requires centers with specific specialization has favored this process of defining care pathways and establishing a network model for the care of these patients. “Thanks to cutting-edge structures of international level with highly specialized professionalism such as the Enets (European Neuroendocrine Tumor Society) certified centers of excellence, in Rome there are the Aou Sant’Andrea and the Policlinico Gemelli, but also thanks to peripheral centers which in have developed internal paths dedicated to these patients over time, Lazio guarantees a healthcare offering that is at the top in terms of number of hospitals able to offer radioligand therapy and levels of expertise, constituting a reference point also for patients from neighboring regions and for some areas of the South”, points out the Itanet president. “However – he adds – there is ample room for improvement to optimize the use of the new therapy and facilitate its adoption, so as to guarantee all patients with a clinical indication for the new treatment the right to access it”.
To “improve the Rlt in the territory and the path of Net patients”, according to Panzuto “it would be desirable to further promote and strengthen the network model and the presence of specific multidisciplinary skills”. This “is a characteristic made even more necessary by this innovative approach, which by its nature makes close collaboration between clinicians of different disciplines indispensable, from the oncologist to the gastroenterologist, from the radiologist to the nuclear doctor, from the surgeon to the endocrinologist, for a in charge of the patient at 360 degrees”.
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