177 Lu-Dota-octreotate radionuclide therapy of advanced gastrointestinal neuroendocrine tumors: results from a phase II study

Abstract

Lu-PRRT was shown to be an effective therapeutic option in our patients with advanced progressive GI-NETs, showing an 84 % DCR (95 % CI 73-95) that lasted for 25 months and a PFS of 36 months. Both activities of 27.8 GBq and 18.5 GBq proved safe and effective in all patients, including those with a higher probability of developing kidney or bone marrow toxicity.

Effect of calculation method on kidney dosimetry in 177Lu-octreotate treatment

“…The main indication is locally advanced or metastatic gastroenteropancreatic NET overexpressing somatostatin receptors upon imaging for somatostatin receptors [2,3]. The activity range of 177 Lu-octreotate usually given is 5.5-7.4 GBq at eight-week intervals [4][5][6][7]. It is common to give four treatments with the possibility of retreatment later on in progression.…”

Persistent Hematologic Dysfunction after Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE: Incidence, Course, and Predicting Factors in Patients with Gastroenteropancreatic Neuroendocrine Tumors

“…Besides encouraging results with regard to symptom relief, the reported number of objective responses was low. Myelodysplastic syndrome (MDS) or leukemia was reported in half of the NET patients who received a very high dosage (>100 GBq) of [ Lu-DOTATATE) results in a better radiological response rate of 15 -35% (3)(4)(5)(6). In general, side effects are mild, although serious hematological toxicity has been reported, making the bone marrow (BM) the main dose-limiting organ.…”

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

“…Radiolabeled somatostatin analogues, like 90 Y-DOTATOC and 177 Lu-DOTATATE, have been demonstrated to be effective for patients who have somatostatin receptor-positive NET. In particular, Paganelli et al [10] reported 177 Lu-DOTATATE to be an effective therapeutic tool in patients with advanced progressive NET, with a disease control rate of 84 % that lasted for 25 months and a progression-free survival of 36 months. Moreover, the authors indicated that both activities of 27.8 GBq and 18.5 GBq are safe and effective in all patients, including those with a higher probability of developing kidney or bone marrow toxicity.…”