Nader Hirmas1, Raya Jadaan2, Akram Al-Ibraheem1. 1. 1Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan. 2. 2Faculty of Medicine, University of Jordan, Amman, Jordan.
Abstract
PURPOSE AND METHODS: Patients with inoperable and metastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). RESULTS: 177Lu-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series. CONCLUSION: Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.
PURPOSE AND METHODS: Patients with inoperable and metastasized neuroendocrine tumors (NETs), particularly those with grades 1 and 2, usually receive treatment with somatostatin analogues (SSAs). Peptide receptor radionuclide therapy (PRRT) has gained momentum over the past two decades in patients who progress on SSAs. 177Lu-DOTATATE is currently the most widely used radiopeptide for PRRT. We reviewed the recent evidence on PRRT and the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). RESULTS: 177Lu-DOTATATE can be used as neoadjuvant treatment in patients with inoperable GEP-NETs, who might be candidate for surgery after treatment and as adjuvant therapy after surgical intervention. Combination treatments of PRRT with chemotherapy or targeted agents as well as combinations of radionuclides in patients with NETs have been explored over the last few years. The majority of patients with NETs experience partial response or have disease stabilization, a small percentage has complete response, while some 30% of patients, however, will have disease progression. The safety and efficacy of retreatment with extra cycles of PRRT as salvage therapy have been evaluated in small retrospective series. CONCLUSION: Overall, there is evidence that disease control and quality of life improve significantly after 117Lu PRRT therapy. Clinical trials on this therapy are scarce, and there is a need for further studies to establish proper management guidelines.
Authors: Christian Waldherr; Miklos Pless; Helmut R Maecke; Tilmann Schumacher; Armin Crazzolara; Egbert U Nitzsche; Andreas Haldemann; Jan Mueller-Brand Journal: J Nucl Med Date: 2002-05 Impact factor: 10.057
Authors: M Cremonesi; M Ferrari; A Di Dia; F Botta; C De Cicco; L Bodei; G Paganelli Journal: Q J Nucl Med Mol Imaging Date: 2011-04 Impact factor: 2.346
Authors: G Rindi; G Klöppel; H Alhman; M Caplin; A Couvelard; W W de Herder; B Erikssson; A Falchetti; M Falconi; P Komminoth; M Körner; J M Lopes; A-M McNicol; O Nilsson; A Perren; A Scarpa; J-Y Scoazec; B Wiedenmann Journal: Virchows Arch Date: 2006-09-12 Impact factor: 4.064
Authors: Elsa M Ronde; Charlotte M Heidsma; Anne M Eskes; Josefine E Schopman; Elisabeth J M Nieveen van Dijkum Journal: Eur J Cancer Care (Engl) Date: 2021-08-30 Impact factor: 2.328
Authors: Satya Das; Liping Du; Aimee Schad; Shikha Jain; Aaron Jessop; Chirayu Shah; David Eisner; Dana Cardin; Kristen Ciombor; Laura Goff; Marques Bradshaw; Dominique Delbeke; Martin Sandler; Jordan Berlin Journal: Endocr Relat Cancer Date: 2021-03 Impact factor: 5.678
Authors: Sofia Koustoulidou; Mark W H Hoorens; Simone U Dalm; Shweta Mahajan; Reno Debets; Yann Seimbille; Marion de Jong Journal: Cancers (Basel) Date: 2021-03-04 Impact factor: 6.639