Personalized Optimization of MNETs-Lu177 Therapy (POPEYE)

The POPEYE project uses advanced computational tools for the optimization of midgut neuroendocrine tumors (MNETs) treatment, towards the personalization of 177Lu therapeutic protocols. MNETs constitute the largest group of gastrointestinal NETs and they are the second most-common small bowel malignancy. Establishing prognosis and guiding patients about the most appropriate course of therapy are both challenging. An interdisciplinary approach exploits established tools and novel developments to increase the early, effective diagnosis and the efficacy of 177Lu radionuclide therapy. MC simulations incorporating ML techniques serve as gold standard and allows to estimate dosimetry on personalized treatment protocols. A well-established management & dissemination plan in combination with an extensive research on economic, ethical, legal and social aspects will allow to achieve POPEYEs final goal; the clinical evaluation and exploitation of the proposed software & hardware tools, as a support guidance to the clinicians, to assess personalized MNETS diagnosis and therapy protocols.

The POPEYE project uses advanced computational tools to optimize the treatment of Midgut Neuroendocrine Tumors (MNETs) to personalize 177Lu radionuclide therapy protocols. MNETs are the largest group of gastrointestinal NETs. They are the second most common malignancy of the small intestine. Establishing a prognosis and informing patients about the most appropriate course of therapy is a challenge. An interdisciplinary approach uses established tools and novel developments to improve the early, effective diagnosis and efficacy of 177Lu radionuclide therapy. Monte Carlo simulations using machine learning techniques serve as the gold standard and enable estimation of dosimetry using personalized treatment protocols tailored to the individual patient. A well-established management and dissemination plan combined with a comprehensive study of the economic, ethical, legal and social aspects of the new therapy will allow to achieve the goal of POPEYE: the clinical evaluation and use of the proposed software and hardware tools to support physicians in the evaluation of personalized MNETS diagnostic and therapeutic protocols. The FWF-funded sub-project of the POPEYE project "Research on the social and economic impact of the proposed personalized methodology and its embedment in health care system" investigated the economic, ethical, legal, and social aspects of the new therapeutic approach using qualitative social science and economic methods. At the beginning of the project, we conducted an overview of the relevant literature and found that there is currently little research on MNET patients and their perspective on radionuclide therapy. We then conducted empirical, qualitative studies in France and Greece to close the research gap. Interviews with nuclear medicine professionals, nurses and hospital managers, and other professionals as well as patients have shown the close link between the activities of professionals aiming to organize radionuclide therapy by, among other things, trying to contain the radiation risk ("taming risk") and the creation of trust among patients in therapy and professionals. Our qualitative research has highlighted social inequalities in access to radionuclide therapy treatment and analyzed patients' experiences and perspectives on treatment. Access to radionuclide therapy is unsystematic and characterized by long and complex treatment paths. An important experience for patients is that they and their needs are taken care of, e.g. by contact persons and by responding to individual needs. An initial cost analysis within the project points to the benefits of treatment, but also to high costs for hospitals, insurance companies, patients, and society. The cooperation between the natural and social sciences in the POPEYE project, which enables a comprehensive assessment of a new treatment method, clearly demonstrates the advantages of interdisciplinary cooperation between the natural and social sciences.