177Lu-DOTATATE therapy in patients with neuroendocrine tumours including high-grade (WHO G3) neuroendocrine tumours

Abstract

Lu-DOTATATE therapy is an important treatment option in somatostatin receptor type-2-positive pancreatic, nonpancreatic gastroenteropancreatic-NETs, and lung NETs including metastatic NETs with an unknown primary site and significantly contributed to patients' OS. Additionally, peptide receptor radionuclide therapy may have a role in a selected subgroup of patients with grade III NET with high somatostatin receptor type-2 expression.

Safety and outcomes of 177Lu‐DOTATATE for neuroendocrine tumours: experience in New South Wales, Australia

“…The estimated median PFS of our patient cohort was lower than rates published in recent studies and could potentially be explained by differences in tumour characteristics. In general, a higher proportion of patients in this evaluation had non‐GEP NET primary sites and tumours with a high Ki‐67 proliferation index, which are associated with poorer PFS, than the published literature.…”

“…Our cohort consisted of a heterogenous population with a range of ages and primary tumour sites. For patients who met all protocol selection criteria, the estimated median OS of 50.7 months was consistent with OS rates from recent large ( n > 50) Australian and international studies . Characteristics associated with better survival were a low Ki‐67 proliferation index and GEP NET primary site.…”

“…For patients who met all protocol selection criteria, the estimated median OS of 50.7 months was consistent with OS rates from recent large (n > 50) Australian and international studies. [10][11][12]15,17,18,21,22 Characteristics associated with better survival were a low Ki-67 proliferation index and GEP NET primary site. The poorer OS observed for NET originating outside the gastroenteropancreatic system suggests that further evidence is required of the benefit of 177 Lu-DOTATATE in the treatment of non-GEP NET.…”

“…Results from the phase III NETTER‐1 trial, published in January 2017, showed that PRRT treatment with 177 Lu‐DOTATATE significantly improved progression‐free survival (PFS) and suggested an overall survival (OS) benefit, when compared with treatment with octreotide long‐acting repeatable in patients with well‐differentiated, metastatic midgut NET . Results from case series have mostly focused on gastroenteropancreatic NET (GEP NET) and have also been encouraging …”

‘Peptide receptor radionuclide therapy in the management of advanced pheochromocytoma and paraganglioma: A systematic review and meta‐analysis’

“…Though the experience with PRRT is predominantly limited to gastroenteropancreatic neuroendocrine tumours, few studies have also evaluated its efficacy and safety in PPGLs . However, the individual studies have been conducted with limited number of patients and the precise effect of PRRT in treatment of advanced PPGLs is currently unclear.…”