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

Temperature responses and distribution of Australian species of Cladophora (Cladophorales: Chlorophyta)

Temperature ranges for survival, growth and sporulation of isolates of 11 Cladophora species from Australia, as well as one isolate from Japan, were tested in constant temperature conditions from 0 to 35-degrees-C at 5-degrees-C intervals over 3 months. These ranges were compared with those previously determined for Cladophora isolates from the North Atlantic Ocean. The Australian endemic species, Cladophora feredayi Harvey, Cladophora valonioides Sonder and Cladophora rhizoclonioidea van den Hoek et Womersley, had stenothermal responses. They are unable to survive below 5-10-degrees-C or above 20-25-degrees-C and have a very narrow growth range (approximately 15-20-degrees-C) which confines them to the southern coasts of Australia. Another group of species occurs in both hemispheres, or has closely related "sister" species in each hemisphere, but is absent from the intervening tropics. Cladophora att. ad pellucida, Cladophora hutchinsioides van den Hoek et Womersley and Cladophora flexuosa (Mueller) Kuetzing from Australia, were less cold tolerant and/or more heat tolerant than their North Atlantic counterparts (Cladophora pellucida (Hudson) Kuetzing, Cladophora hutchinsiae (Dillwyn) Kuetzing, C. flexuosa and the related species, Cladophora sericea (Hudson) Kuetzing). A third group of species occurs in both hemispheres and is widely distributed through the tropics. Cladophora vagabunda (L.) van den Hoek, Cladophora laetevirens (Dillwyn) Kuetzing and Cladophora lehmanniana (Lindenberg) Kuetzing isolates from Australia, and Cladophora albida (Hudson) Kuetzing isolates from Australia and Japan had similar responses to isolates from the North Atlantic. In contrast, Cladophora montagneana Kuetzing, from Australia and Curacao, had very different responses. Only two of the 11 species studied (C. feredayi and C. vagabunda) have sufficient collections in Australia to show that they occur over the full potential geographic range allowed by their physiological tolerance. All other species could be expected to extend beyond their present known range on the basis of their temperature responses and the seasonal sea temperatures around the Australian coast

Significant changes in dietary intake and supplement use after breast cancer diagnosis in a UK multicentre study

The diagnosis of cancer can motivate survivors to alter their lifestyle habits. Healthcare providers need to be aware of what changes patients are likely to make in order to derive more pertinent recommendations; however, few studies have reported pre- and post-diagnostic lifestyle behaviours. Semi-quantitative food frequency questionnaires (FFQs) completed approximately 1 year after diagnosis were used to evaluate dietary intake and supplement use before and after diagnosis in a cohort of 1,560 breast cancer patients participating in the UK, prospective DietCompLyf study. Intake of fruit and vegetables, wholegrains and lean sources of protein increased significantly post-diagnosis (P < 0.05, each). Conversely, after diagnosis consumption of high-fat, high-sugar products, red meat, coffee, some alcoholic drinks and refined grains significantly decreased (P < 0.05, each). Post-diagnostic changes in diet were accompanied by changes in the intake of macronutrients and a number of vitamins and minerals. Supplement use was highly prevalent (56.1%) pre-diagnosis, increasing to 62.8% after diagnosis (P = 0.001). Fish oils, multivitamin and minerals, and evening primrose oil were most often used and the proportion of users significantly increased (P < 0.05, each) after diagnosis. The percentage of women using oestrogenic botanical supplements (OBSs) was small but more than doubled to 8.4% after diagnosis (P < 0.05). British women participating in the DietCompLyf study reported significant changes in dietary intake and supplement use after their breast cancer diagnosis. These findings contribute to our understanding of female cancer survivors' dietary behaviours which is crucial for developing and implementing recommendations