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68Ga Advancements....

[68Ga-DOTA,Tyr3]octreotide (DOTA-TOC)

[68Ga-DOTA,1-Nal]octreotide (DOTA-NOC)*

[68Ga-DOTA]-TATE*

[68Ga-DOTA]-Lanreotide

[68Ga-DOTA]-Bombesin / AMBA* and DEMOBESIN*

[68Ga-DOTA]-D-Glu-Gastrin (MTC, NET)*

[68Ga-DOTA]-F(ab’)2-herceptin (breast cancer)

68Ga-Citrate (infection, inflammation)

68Ga-DOTA-Tyrosin (brain tumors)*

68Ga-DOTA-HSA Microspheres (lung perfusion)*

68Ga-NODAGA-RGD (angiogenesis)*

68Ga-BPAMP (osteoblastic metastases)*

68Ga-DOTA-MSH (melanoma)*

68Ga-DOTA-SHAL (lymphoma)*

68Ga-PSMA (prostate cancer)

68Ga-CXCR4 (acdenocarcinomas)

* first performed at Bad Berka

World Map of Ga68 (10/1/13)

Bad Berka

bit.ly/ga68map

You are going where ?

June 2011

400+ Medical Professionals

5 patients

Invited to join the SNMMI and subsequently the GA68 working group

A Word document later - Go2BadBerka.info

  • First Ga68 Scan - no new info
  • First PRRT (Y90) reduced Octreotide by 2/3
  • Second PRRT (Tandem) eliminated Octreotide
  • Third PRRT (Tandem) 1/10
  • Eighth Ga68 Scan 10/28

Tom O'Dorisio

Right Care, Right Patient, and Right Time

Eric Liu

Michael Schultz

Ajit Padhy

All substance are poisons, there are none which is not a poison. The right dose differentiates a poison and a remedy. Paracelsus ca. 1493-1541

PRRTInfo.org - March 2011 Launch

1,500 unique visitors every month

News and practical information on what PRRT is and how to travel for treatment

  • Patients
  • Support Providers
  • Medical Professional

Funded and run by patients for patients

Top Articles (all viewed 1,000+ times)

  • Audio and Video Recordings From 1st World Congress
  • How to contact the Clinic
  • 1st World Congress on Ga-68 and Peptide Receptor Radionuclide Therapy
  • FAQs
  • First World Congress of Ga-68 and PRRNT - an Overwhelming Success
  • Centers that offer PRRT
  • What are the Risk and Side Effects of PRRT
  • PRRT Results
  • How Does PRRT Work
  • What is PRRT?
  • Who Should Consider PRRT
  • PRRT Background and Types
  • Restaging / Follow on Treatment

Top Search Items

(over 15,000 site searches)

  • PRRT
  • Bad Berka
  • Patient
  • Pet/Ct
  • Baum
  • Treatment
  • Information
  • Neuroendocrine
  • Nuclear
  • Medicine
  • Zentralklinik
  • Gallium
  • Scan
  • Lu177
  • Hotel
  • Conference

Lesson learned...

So much more than a 15 minute talk can do justice

  • It is Ga68 not Gallium
  • More than just for NETs
  • Cheap enough that centers can roll their own
  • PRRT describes a whole set of therapeutic options - not just one
  • Different peptides, isotopes, delivery methods
  • While the studies are very promising - they are retrospective not prospective.
  • US was doing phase I work a decade ago...

Vancouver

20 phone calls

Six face to face meetings

Numerous drafting sessions - a pathway towards approval

48 page power point - 20 page imaging manual - 1 poster

Toronto

October 2008 - Conference on NETs

PET/CT in NeuroEndocrine Tumours Session

A better imaging method for NETs

University of Iowa

Ga-68 DOTATOC positive in only 1/22 patients presenting with symptoms / labs suggestive of elevated serotonin without diagnosis of NET (false positive)

Ga-68 DOTATOC identified primary tumor in 14/20 pts with metastatic disease, 7 have gone to surgery to remove primary. 2 others confirmed by biopsy. Conventional imaging found 3.

What is taking so long

DOTATATE

US/Canada: Expires in 2015

Europe: Expires in 2014

DOTATOC

US/Canada: Expires in 2014

Europe: Expires in 2015

DOTANOC

US: Expires in 2022 (BioSynthema)

Everywhere else: expired

San

Francisco

Patient Perspective on Molecular Imaging and Therapy.

Josh Mailman

President, NorCal CarciNET

Chair, Patient Advocacy and Advisory Board SNMMI

Member, GA68 Working Group

and a bunch of other stuff...

Disclosures - None

It all starts with a diagnosis

For many this is easier said then done

  • INDs are not NDAs ...
  • Patents are all over the place
  • No deep pockets to fund
  • Government funds are small
  • Reimbursement for scans are bundled and reduce
  • We have other scans - will this really change management
  • FDA wants "in" prior to international study start
  • PRRT not a pill but a collection of therapies

Objectives

  • Learn more about Ga68 and PRRT from a patient perspective
  • Better understanding of the challenges in making both Ga68 and PRRT more widely available in the US

Once Dx - there are options - but what path to choose ?

  • Surgery
  • Ablation / Embolization
  • Octreotide
  • Newer Drugs
  • Wait and See / Learn

and how do you talk to people who have been there before...

Some Su

Vanderbilt

Clinical efficacy analysis: Change of patient’s management 80 patients (2011-13)

No impact: 48% of patients

Inter-modality change: 42% (33/80)

Candidates for surgery: 15% (12/80), 2/3 UP

Not candidates for surgery: 4% (3/80), 1/9 diagnosis

Candidates for PRRT: 20% (16/80)

Not candidates for PRRT: 3% (2/80)

Intra-modality change: 10% (8/80)

Change in surgical plans: 3.5% (3/80)

Additional PRRT: 3.5% (3/80)

Refer to endoscopic ultrasound: 3% (2/80)

Conclusions: change in patient’s management

Restaging NET: 57% (40/70)

Diagnosis: 11% (1/9)

Chandighar, India

Selected Papers can be found at http://prrtinfo.org/index.php/news/113-pre-second-world-ga68-congress-publication

Complete abstracts: www.wjnm.org/showBackIssue.asp?issn=1450-1147;year=2013;volume=12;issue=3;month=February;supp=Y

Videos of the conference: http://itr8.com/hosted/chandighar/presentation_links.htm

Patient Perspective on Molecular Imaging and Therapy

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