Bad Berka Information- Required Info for letter to Dr Richard Baum, Dr Baum EMAIL, PRRT treatment steps & PRRT VIDEO & 2 different PRRT study data!

 PRRT and BAD BERKA INFORMATION- what you need for the letter, treatment process, presentation by Dr Baum and EMAIL ADDRESS. Included 2 PRRT studies. 

The following information is required before Peptide Receptor Radionuclide Therapy (PRRT)- @Bad Berka Clinic in Germany & Dr Baum's address, plus VIDEO of PRRT & GALLIUM 68 SCAN: Here is some information on requirements for PRRT therapy. As noted, this is serious business. and one should work, and get aligned with, your Oncologist/MD before proceeding with such treatment. It is strongly advised that your MD make the referral to the clinic, or include a letter from her/him agreeing to the therapy.

When I went, I saw 2 MD's in the USA- one a Oncologist, the other a Surgeon, who were advising I undertake this therapy SAP due to my condition. I talked to them both along the way with questions and preparation. It was very helpful to have your MD supportive and advising such a treatment.

This is the information supplied to me by Dr Baum @ Bad Berka regarding PRRT treatment requirements and information:

This is what you will need to pre-send to Dr Richard Baum
- all medical (histological and surgical) reports, pathology reports

- recent reports of CT, MRI, sonography, endoscopy

- PET, PET/CT, CT or MRI studies (if performed) on CD (in DICOM format if possible)

- OctreoScan study (original images or study on CD) - this is definitely needed in any case before! Alternatively Ga-68 DOTA-TOC PET study on CD in DICOM format.

- recent blood tests and laboratory values (blood counts (RBC, WBC, platelets), creatinine, urea, liver transaminases)

We will perform at the Zentralklink Bad Berka the following studies:
- somatostatin receptor PET/CT (with Ga-68 DOTA-NOC) for dosimetry purposes.
This PET/CT study will also serve as a control for follow-up (evaluation of therapy response) and is most important.
- GFR measurement using Tc-99m DTPA (if not done within the last 6 weeks)
- kidney scintigraphy using Tc-99m MAG3 for measuring the tubular function (if not done within the last 6 weeks)
- full laboratory tests, including all relevant tumor markers in blood (e.g. chromogranin A, serotonin, gastrin etc.)

•  The Ga-68 PET/CT and the other tests can be performed also as outpatient (patient must be here in the hospital at 9 hrs a.m.)
• Radionulice therapy (PRRT) will be performed as inpatient treatment on our isotope nuclear medicine ward.
• 
  
  Patient can leave the hospital usually on the 3rd day after the treatment in the morning.

Tel: +49 (364) 585-2200 FAX: +49 (364) 585-3515

Prof. Dr. med. Richard P. Baum

Dept. of Nuclear Medicine – Center for PET/CT

Zentralklinik Bad Berka

99437

Email:  richard.baum@zentralklinik.de
   

2) info@rpbaum.de (this is an old address still active but use #1 as main (* I would send to both*)

Web site: www.zentralklinik-bad-berka.de

Also, below is PART 1 and Part 2 of a video of Dr Baum, the disease, Pet w/GA 68, PRRT treatment which I will be undertaking myself.
It was this video that got me going in the right direction with PRRT and Bad Berka and Dr Baum!

http://www.youtube.com/user/renalcarcinoidguy#p/f/0/Z0TlXH2dVi8

http://www.youtube.com/user/renalcarcinoidguy#p/f/1/S74LNxXOaSw

*THIS VIDEO WAS UPLOADED TO UTUBE COURTESY OF CNETS SINGAPORE AND CARING FOR CARCINOID FOUNDATION. Thanks to both! (links of their site on the left)

---------------------------------------------------------------------------------------------------------------------------------- STUDY DATA#1

ASCO :ARTICLE ON AMERICAN SOCIETY OF CLINICAL ONCOLOGY

J Clin Oncol 26: 2008 (May 20 suppl; abstr 4517) Authors: D. Hörsch, V. Prasad, R. P. Baum-- (ALL Bad Berka Staff)!

Citation:

Longterm outcome of peptide receptor radionuclide therapy (PRRT) in 454 patients with progressive neuroendocrine tumors using
yttrium-90 and lutetium-177 labelled somatostatin receptor targeting peptides.

Background: Peptide receptor radionuclide therapy (PRRT) is an important new treatment for patients with metastasized neuroendocrine tumors (NET)
resistant to biotherapy or chemotherapy. Yttrium-90 (Y-90)- and/or lutetium-177 (Lu-177) DOTA-TATE (Lu-TATE) have been used alone or in combination over
the last 6 years by us in patients with progressive neuroendocrine tumors. Lu-TATE was predominantly used for small metastases or in patients with impaired
renal or hematological function. Methods: 454 pts (mean age 59.1 years, 248 m, 206f) received a total of 1,303 administrations (mean activity 4.2 GBq, max.
7.5 GBq per cycle, time between courses 3 to 6 months). For kidney protection, 1.5 L of an AA solution (arginine/lysine) were infused IV over 4 hrs. Staging
was performed by CT/MRI and Ga- 68 DOTA-NOC PET-CT or FDG/fluoride PET/CT, blood chemistry and tumor markers (CgA, serotonin). Renal function was
serially determined (Tc-99m MAG3 scan/clearance (TER) and Tc-99m DTPA/GFR measurements). Tumor dosimetry (MIRD/OLINDA) was performed after
PRRT (serial scintigraphies). All data were entered in a structured ACCESS database (284 items/patient). Results: Significant hematological toxicity (mainly
erythrocytopenia, rarely neutropenia, thrombocytopenia) occurred in less than 15% of all patients.

End stage renal insuffiency was not observed in any of the
patients with normal kidney function before PRRT. In most patients receiving Lu-TATE alone (n=417 cycles) serum creatinine and TER/GFR did not change.

Tumor response in patients with NETs of non-pancreatic origin and pancreatic NET after a mean follow-up of 2 years:

• 73/76% stable disease (progressive
• disease before),
• 15/17% had partial and complete remissions and
• 12/7% PD. progressive disease

36 patients with advanced disease died of PD.

Objective tumor responses
(including improvement of clinical symptoms) were seen in 88/93% of the patients.

Conclusions: Fractionated, individualized PRRT with lower administered

radioactivity given over a longer period of time results in good therapeutic responses in patients with progressive neuroendocrine tumors.

===========================================================================

STUDY DATA #2 

PRRT Information from Rotterdam Clinic and link to the site (Erasmus Medical Center)

Link: http://www.prrt.nl/index.php

STUDY RESULTS OF Lutetium-octreotate 177 @ Erasmus

From January 2000 until August 2006 1772 treatments with
lutetium-octreotate were given to a sum of 504 patients. Most
patients had neuroendocrine tumours. A preliminary analysis
in 310 patients with so-called gastroenteropancreatic tumours was
performed after obtaining all results after finishing the treatment. showed a

This

• decrease in the size of the tumours in 46% of patients,
• stable disease in 35%
•  and progression of the tumour despite treatment in 20%.

A significant improvement of quality of life in those patients

with tumour regression was also noted.

The average duration of the effect of therapy was 40 months- calculated from the start of therapy.
 
In addition, there are strong indications that patients
treated with Lutetium-octreotate, on average, survive several years longer (3-6 years) than patients who did not get this treatment.

Why is PRRT Therapy not available in the USA and Canada for NET/Carcinoid Tumors????