While being treated in our STING clinic, you may undergo the following pathology tests or scans. These may require specific preparation. We have outlined some of the common tests and preparation below.
This is the most established blood-based tumour marker for neuroendocrine tumours. We may use this test once or twice a year to evaluate tumour growth or recurrence. It is elevated in 60-100% of patients with neuroendocrine tumours.
However, this test can be falsely elevated (a false positive) with certain medications and conditions. If you are taking any of the following tablets, please stop them TWO (2) weeks before your blood test:
1. Pantoprazole (Somac)
2. Omeprazole (Losec)
3. Esomeprazole (Nexium)
This test can also take 2 weeks minimum to be processed, so we recommend doing it 3-4 weeks prior to your clinic appointment to ensure we have the result available.
This test measures the amount of 5-HIAA in a 24 hour collection of urine. This is a breakdown product of the hormone serotonin and reflects whether your neuroendocrine tumour is over-producing hormones to cause carcinoid syndrome. This test has specific instructions regarding the timing of urine collections and specific foods to avoid 2 days prior to the test and for the duration of the test.
This is the specific PET scan for neuroendocrine tumours. Please ensure you are well hydrated.
We generally schedule scans for 3-4 weeks after your long-acting somatostatin analogue injection
(lanreotide or sandostatin). If you have recently had your SSA injection, please let the technician know on
the day.
This is a ‘standard’ PET scan that injects a glucose radiotracer to identify high grade tumours.
Please fast for 6 hours prior to your scan appointment.
If you have diabetes, please fast for 4 hours and ensure your blood sugar level is (?? Not actually sure about the diabetic advice @Sarennya Pathmanandavel (South Eastern Sydney LHD) could you fluff this out a bit – how long does each scan take, how early should you arrive, are you radioactive after, etc?)
Papers
Lin E, Chen T, Little A, Holliday L, Roach P, Butler P, Hosking E, Bailey E, Elison B, Currow D. Safety and outcomes of 177 Lu-DOTATATE for neuroendocrine tumours: experience in New South Wales, Australia. Intern Med J. 2019 Oct;49(10):1268-1277. doi: 10.1111/imj.14336. PMID: 31062490. https://onlinelibrary.wiley.com/doi/10.1111/imj.14336
Li M, Chan DL, Tapia Rico G, Cehic G, Lawrence B, Wyld D, Pattison DA, Kong G, Hicks R, Michael M, Kiberu AD, Lim J, Clifton-Bligh R, Tsang V, Roach PJ, Leyden J, Diakos CI, Price TJ, Pavlakis N. Australasian Consensus Statement on the Identification, Prevention, and Management of Hormonal Crises in Patients with Neuroendocrine Neoplasms Undergoing Peptide Receptor Radionuclide Therapy. Neuroendocrinology. 2023;113(3):281-288. doi: 10.1159/000526848. Epub 2022 Sep 1. PMID: 36049462.
Oral presentations
NABNEC: A randomised phase II study of nab-paclitaxel in combination with carboplatin as first line treatment of gastrointestinal neuroendocrine carcinomas (GI-NECs). Authors: Lorraine A. Chantrill, David Ransom, David Chan, Adnan Nagrial, Nick Pavlakis, Ben Markman, Christos Stelios Karapetis, Katrin Marie Sjoquist, John Simes, Val Gebski, Michael S Hofman, Pablo Gonzalez Ginestet, Anthony J. Gill, Sonia Yip, Michael Michael, Anthony Jaworski, Ho Wai Derrick Siu, Mustafa Khasraw. Journal of Clinical Oncology 2024 42:3_suppl, 589-589. DOI:10.1200/JCO.2024.42.3_suppl.589 – presented at ASCO GI 2024
Australasian Gastrointestinal Trials Group (AGITG) CONTROL NET Study: 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) and capecitabine plus temozolomide (CAPTEM) for pancreas and midgut neuroendocrine tumours (pNETS, mNETS)—Final results. Nick Pavlakis, David Turner Ransom, David Wyld, Katrin Marie Sjoquist, Kate Wilson, Val Gebski, James Murray, Andrew Ddembe Kiberu, Matthew E. Burge, William Macdonald, Paul Roach, David A. Pattison, Patrick Butler, Timothy Jay Price, Michael Michael, Benjamin James Lawrence, Dale L. Bailey, Simone Leyden, John Raymond Zalcberg, Harvey Turner. Journal of Clinical Oncology 2022 40:16_suppl, 4122-4122. https://ascopubs.org/doi/10.1200/JCO.2020.38.4_suppl.604
Posters
Safety and outcomes of 177Lu-DOTATATE for neuroendocrine tumours: the St George Hospital experience. Authors: Amanda Tam1, Maryanne Dijkstra1, Lillian Lan1, Katrin Sjoquist, David Thomas, Winston Liauw, Carol Yazbeck, Erika Hosking, Patrick Butler, Jennifer Lim. Presented at the Medical Oncology Group of Australia Annual Scientific Meeting 2024
Retrospective analysis of patients with progressive metastatic neuroendocrine tumours re-treated with 177-Lutetium-DOTATATE: The St George Hospital Experience . Authors: Lillian Lan, Amanda Tam, Maryanne Dijkstra, Katrin Sjoquist, David Thomas, Winston Liauw, Carol Yazbeck, Erika Hosking, Patrick Butler, Jennifer Lim. Presented at the Medical Oncology Group of Australia Annual Scientific Meeting 2024
Impact of travel distance on outcomes for patients with neuroendocrine tumours receiving peptide receptor radioligand therapy – a single institution experience . Authors: Maryanne Dijsktra, Lillian Lan, Amanda Tam, Katrin Sjoquist, David Thomas, Winston Liauw, Yu Jo Chua, Ankit Jain, David Chan, Girish Mallesara, Carol Yazbeck, Erika Hosking, Patrick Butler, Jennifer Lim. Presented at the Medical Oncology Group of Australia Annual Scientific Meeting 2024
As one of the original lutate centres in NSW, we have helped pioneer this treatment. We are highly experienced in this subspecialised field and are proud to offer this treatment as part of a multidisciplinary clinic.
