Jolanta Kunikowska1, Dariusz Pawlak2, Marianna I Bąk3, Beata Kos-Kudła4, Renata Mikołajczak2, Leszek Królicki5. 1. Nuclear Medicine Department, Medical University of Warsaw, ul. Banacha 1 a, 02-097, Warsaw, Poland. jolanta.kunikowska@wum.edu.pl. 2. Radioisotope Centre POLATOM, National Centre for Nuclear Research, ul. Andrzeja Sołtana 7, 05-400, Otwock-Świerk, Poland. 3. Department of Internal Medicine and Diabetology, Medical University of Warsaw, ul. Banacha 1 a, 02-097, Warsaw, Poland. 4. Division of Endocrinology, Department of Pathophysiology and Endocrinology, Medical University of Silesia, ul. Ceglana 35, 40-514, Katowice, Poland. 5. Nuclear Medicine Department, Medical University of Warsaw, ul. Banacha 1 a, 02-097, Warsaw, Poland.
Abstract
INTRODUCTION: The peptide receptor radionuclide therapy (PRRT) with 90Y and 177Lu is a form of molecular targeted therapy for inoperable or disseminated neuroendocrine tumors (NET). AIM: The aim of the study was to evaluate clinical results and long-term side effects of tandem 90Y /177Lu-DOTATATE therapy in patients with NET. Additionally, we evaluated clinical results with reference to the primary site. MATERIALS AND METHODS: 59 patients with disseminated NET were included in the study prospectively. 3-5 cycles of combined 1:1 90Y/177Lu-DOTATATE (total injected activity 11.1-16.65 GBq) with mixed amino acids for kidney protection were performed. RESULTS: During a median follow-up of 75.8 months, the PFS was 32.2 months, and the OS was 82 months; 25 patients died. Depending on primary tumor's site, the PFS and the OS for pancreatic NET vs. small bowel, NET vs. large bowel, NET were 30.4 vs. 29.5 vs. 40.3 and 78.9 vs. 58.1 vs. 82.5, respectively. The observed 5-year overall survival was 63%, and a 2-year risk of progression was 39.4%. The following imaging response was observed: CR in 2%, PR in 22%, SD in 65%, and PD in 6% patients. The disease control rate was 89%. The objective response rate was 24%. The PRRT was well tolerated by all patients. One patient (2%) revealed MDS, and one patient (2%) grade 3 nephrotoxicity. No other grade 3 and 4 hematological or renal toxicity was observed. CONCLUSIONS: These results indicated the tandem 90Y/177Lu-DOTATATE therapy for patients with disseminated/inoperable NET as highly effective and safe, considering long-term side effects. In the majority of patients, clinical improvement was observed.
INTRODUCTION: The peptide receptor radionuclide therapy (PRRT) with 90Y and 177Lu is a form of molecular targeted therapy for inoperable or disseminated neuroendocrine tumors (NET). AIM: The aim of the study was to evaluate clinical results and long-term side effects of tandem 90Y /177Lu-DOTATATE therapy in patients with NET. Additionally, we evaluated clinical results with reference to the primary site. MATERIALS AND METHODS: 59 patients with disseminated NET were included in the study prospectively. 3-5 cycles of combined 1:1 90Y/177Lu-DOTATATE (total injected activity 11.1-16.65 GBq) with mixed amino acids for kidney protection were performed. RESULTS: During a median follow-up of 75.8 months, the PFS was 32.2 months, and the OS was 82 months; 25 patients died. Depending on primary tumor's site, the PFS and the OS for pancreatic NET vs. small bowel, NET vs. large bowel, NET were 30.4 vs. 29.5 vs. 40.3 and 78.9 vs. 58.1 vs. 82.5, respectively. The observed 5-year overall survival was 63%, and a 2-year risk of progression was 39.4%. The following imaging response was observed: CR in 2%, PR in 22%, SD in 65%, and PD in 6% patients. The disease control rate was 89%. The objective response rate was 24%. The PRRT was well tolerated by all patients. One patient (2%) revealed MDS, and one patient (2%) grade 3 nephrotoxicity. No other grade 3 and 4 hematological or renal toxicity was observed. CONCLUSIONS: These results indicated the tandem 90Y/177Lu-DOTATATE therapy for patients with disseminated/inoperable NET as highly effective and safe, considering long-term side effects. In the majority of patients, clinical improvement was observed.
Entities:
Keywords:
90Y/177Lu-DOTATATE; Neuroendocrine tumors.; PRRT; Somatostatin receptor; Tandem therapy
Authors: Rudolf A Werner; Thorsten Derlin; Steven P Rowe; Lena Bundschuh; Gabriel T Sheikh; Martin G Pomper; Sebastian Schulz; Takahiro Higuchi; Andreas K Buck; Frank M Bengel; Ralph A Bundschuh; Constantin Lapa Journal: J Nucl Med Date: 2020-08-28 Impact factor: 10.057
Authors: Else A Aalbersberg; Daphne M V de Vries-Huizing; Margot E T Tesselaar; Marcel P M Stokkel; Michelle W J Versleijen Journal: Cancer Imaging Date: 2022-06-17 Impact factor: 5.605
Authors: Bryson W Katona; Giorgio A Roccaro; Michael C Soulen; Yu-Xiao Yang; Bonita J Bennett; Brian P Riff; Rebecca A Glynn; Damian Wild; Guillaume P Nicolas; Daniel A Pryma; Ursina R Teitelbaum; David C Metz Journal: Pancreas Date: 2017-10 Impact factor: 3.327
Authors: Jason M Heckert; Sarit T Kipnis; Shria Kumar; Samuel Botterbusch; Alice Alderson; Bonita Bennett; Caroline Creamer; Jennifer R Eads; Michael C Soulen; Daniel A Pryma; David A Mankoff; David C Metz; Bryson W Katona Journal: Oncologist Date: 2020-03-06