The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours

Peptide receptor radionuclide therapy (PRRNT) is a molecularly targeted radiation therapy involving the systemic administration of a radiolabelled peptide designed to target with high affinity and specificity receptors overexpressed on tumours. PRRNT employing the radiotagged somatostatin receptor agonists (90)Y-DOTATOC ([(90)Y-DOTA(0),Tyr(3)]-octreotide) or (177)Lu-DOTATATE ([(177)Lu-DOTA(0),Tyr(3),Thr(8)]-octreotide or [(177)Lu-DOTA(0),Tyr(3)]-octreotate) have been successfully used for the past 15 years to target metastatic or inoperable neuroendocrine tumours expressing the somatostatin receptor subtype 2. Accumulated evidence from clinical experience indicates that these tumours can be subjected to a high absorbed dose which leads to partial or complete objective responses in up to 30 % of treated patients. Survival analyses indicate that patients presenting with high tumour receptor expression at study entry and receiving (177)Lu-DOTATATE or (90)Y-DOTATOC treatment show significantly higher objective responses, leading to longer survival and improved quality of life. Side effects of PRRNT are typically seen in the kidneys and bone marrow. These, however, are usually mild provided adequate protective measures are undertaken. Despite the large body of evidence regarding efficacy and clinical safety, PRRNT is still considered an investigational treatment and its implementation must comply with national legislation, and ethical guidelines concerning human therapeutic investigations. This guidance was formulated based on recent literature and leading experts’ opinions. It covers the rationale, indications and contraindications for PRRNT, assessment of treatment response and patient follow-up. This document is aimed at guiding nuclear medicine specialists in selecting likely candidates to receive PRRNT and to deliver the treatment in a safe and effective manner. This document is largely based on the book published through a joint international effort under the auspices of the Nuclear Medicine Section of the International Atomic Energy Agency

Representações sociais do medicamento genérico por consumidores residentes em Natal, Rio Grande do Norte, Brasil Social representations of generic drugs by consumers from Natal, Rio Grande do Norte, Brazil

O trabalho objetivou determinar os núcleos central e periférico das representações sociais do medicamento genérico por consumidores, estabelecendo mecanismos que poderão ser utilizados no aprimoramento da política desse tipo de medicamento no Brasil. A pesquisa foi realizada no período de abril de 2002 a fevereiro de 2003, na Cidade do Natal, Rio Grande do Norte, com quatrocentos consumidores. O teste utilizado foi o de associação de palavras, e o estímulo indutor, as palavras medicamento genérico. Foi solicitada a evocação de três palavras, de acordo com a estratégia de acesso ao Núcleo Central de Vergès. A análise dos dados foi realizada com o auxílio do programa EVOC 2000 e da análise de conteúdo preconizada por Bardin. Os resultados demonstraram que o núcleo central era composto pelas categorias preço, qualidade e equivalência farmacêutica, e o sistema periférico, representado pelas categorias opção, eficácia, governo, benefício social e acessibilidade.<br>This paper aimed to determine the central and peripheral roles of consumers' social representations concerning generic drugs, establishing mechanisms that could be used to improve policies for this type of medication in Brazil. The research was done from April 2002 to February 2003 in the city of Natal, Rio Grande do Norte, with 400 consumers. The study employed the word association test with the words "generic drug" as the inductive stimulus. Evocation of three words was requested, according to the access strategy to Vergès' Central Nucleus. Data analysis used the EVOC 2000 software and the content analysis proposed by Bardin. The results demonstrated that the central nucleus consisted of the categories price, quality, and pharmaceutical equivalence, while the peripheral system was represented by the categories option, effectiveness, government, social benefit, and accessibility