Combination Therapies with PRRT

Yordanova, Anna; Ahmadzadehfar, Hojjat

doi:10.3390/ph14101005

Cited by 9 publications

(9 citation statements)

References 79 publications

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“…Therefore, many approaches are being explored to improve therapeutic effects of PRRT, such as combination therapies, PRRT with αradionuclides, and PRRT with antagonists. [230,231]…”

Section: Prrt In Pnetsmentioning

confidence: 99%

Perspective of molecular imaging and peptide receptor radionuclide therapy in pancreatic neuroendocrine tumors: where do we stand?

Zhu

Liu

Huo

2023

Journal of Pancreatology

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The clinical use of nuclear medicine imaging and therapy in pancreatic neuroendocrine tumors has been greatly strengthened since the approval of 68 Ga-DOTATATE and 177 Lu-DOTATATE. However, many aspects are still under discussion. In this 2-part article, we aim to collect and discuss current evidence of molecular imaging and peptide receptor radionuclide therapy (PRRT) in pancreatic neuroendocrine tumor. In the first part, we will address some critical aspects of 68 Ga-SSAs imaging, including diagnostic efficacy, recurrence detection and follow-up, patient selection for PRRT, and pitfalls in image interpretation. Besides, we will also briefly discuss the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography, special imaging strategy in regard to insulinoma, and the status of radiolabeled somatostatin receptor antagonist. In the second part, we aim to review the current evidence of PRRT in pancreatic neuroendocrine tumor, focusing on efficacy and safety in particular. We will also introduce the recent development of PRRT, including PRRT in high-grade neuroendocrine neoplasms, retreatment PRRT, upfront PRRT, PRRT in the setting of neoadjuvant therapy and conversion therapy, combination therapies with PRRT, PRRT with αradionuclides, and PRRT with antagonists.

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“…Therefore, many approaches are being explored to improve therapeutic effects of PRRT, such as combination therapies, PRRT with αradionuclides, and PRRT with antagonists. [230,231]…”

Section: Prrt In Pnetsmentioning

confidence: 99%

Perspective of molecular imaging and peptide receptor radionuclide therapy in pancreatic neuroendocrine tumors: where do we stand?

Zhu

Liu

Huo

2023

Journal of Pancreatology

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“…With increasing efforts to increase the proportion of patients who respond to PRRT with the use of radio-sensitizers or agents to increase somatostatin receptor expression, this issue is of even greater importance. Several studies have suggested the synergistic anti-tumor effect of combining PRRT [ 376 , 377 ] with other treatments. SSAs [ 220 ], everolimus [ 378 ] and chemotherapy with capecitabine and temozolomide, can function as radio-sensitizer [ 379 ] with PRRT.…”

Section: Controversies and Uncertainties Of Predicting Therapeutic Re...mentioning

confidence: 99%

Predictive Factors for Resistant Disease with Medical/Radiologic/Liver-Directed Anti-Tumor Treatments in Patients with Advanced Pancreatic Neuroendocrine Neoplasms: Recent Advances and Controversies

Lee

Ramos-Álvarez

Jensen

2022

Cancers

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Purpose: Recent advances in the diagnosis, management and nonsurgical treatment of patients with advanced pancreatic neuroendocrine neoplasms (panNENs) have led to an emerging need for sensitive and useful prognostic factors for predicting responses/survival. Areas covered: The predictive value of a number of reported prognostic factors including clinically-related factors (clinical/laboratory/imaging/treatment-related factors), pathological factors (histological/classification/grading), and molecular factors, on therapeutic outcomes of anti-tumor medical therapies with molecular targeting agents (everolimus/sunitinib/somatostatin analogues), chemotherapy, radiological therapy with peptide receptor radionuclide therapy, or liver-directed therapies (embolization/chemoembolization/radio-embolization (SIRTs)) are reviewed. Recent findings in each of these areas, as well as remaining controversies and uncertainties, are discussed in detail, particularly from the viewpoint of treatment sequencing. Conclusions: The recent increase in the number of available therapeutic agents for the nonsurgical treatment of patients with advanced panNENs have raised the importance of prognostic factors predictive for therapeutic outcomes of each treatment option. The establishment of sensitive and useful prognostic markers will have a significant impact on optimal treatment selection, as well as in tailoring the therapeutic sequence, and for maximizing the survival benefit of each individual patient. In the paper, the progress in this area, as well as the controversies/uncertainties, are reviewed.

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“…This can facilitate treatments adapted according to the size and distribution of metastatic deposits identified on imaging. However, this is not currently recommended; prospective, randomized studies are needed to confirm improvements in progression-free survival using combination radionuclide therapy before this is clinically implemented [129]. This also needs to be weighed against potential nephrotoxic consequences, which have been shown to be significantly more common both transiently and persistently in patients treated with 90 Y and combination 90 Y + 177 Lu compared with 177 Lu alone in a study of 807 patients [130].…”

Section: Future Directions For Prrtmentioning

confidence: 99%

Treatment of Neuroendocrine Neoplasms with Radiolabeled Peptides—Where Are We Now

Naik¹,

Al-Nahhas²,

Khan³

2022

Cancers

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Peptide receptor radionuclide therapy (PRRT) has been one of the most successful and exciting examples of theranostics in nuclear medicine in recent decades and is now firmly embedded in many treatment algorithms for unresectable or metastatic neuroendocrine neoplasms (NENs) worldwide. It is widely considered to be an effective treatment for well- or moderately differentiated neoplasms, which express high levels of somatostatin receptors that can be selectively targeted. This review article outlines the scientific basis of PRRT in treatment of NENs and describes its discovery dating back to the early 1990s. Early treatments utilizing Indium-111, a γ-emitter, showed promise in reduction in tumor size and improvement in biochemistry, but were also met with high radiation doses and myelotoxic and nephrotoxic effects. Subsequently, stable conjugation of DOTA-peptides with β-emitting radionuclides, such as Yttrium-90 and Lutetium-177, served as a breakthrough for PRRT and studies highlighted their potential in eliciting progression-free survival and quality of life benefits. This article will also elaborate on the key trials which paved the way for its approval and will discuss therapeutic considerations, such as patient selection and administration technique, to optimize its use.

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Combination Therapies with PRRT

Cited by 9 publications

References 79 publications

Perspective of molecular imaging and peptide receptor radionuclide therapy in pancreatic neuroendocrine tumors: where do we stand?

Perspective of molecular imaging and peptide receptor radionuclide therapy in pancreatic neuroendocrine tumors: where do we stand?

Predictive Factors for Resistant Disease with Medical/Radiologic/Liver-Directed Anti-Tumor Treatments in Patients with Advanced Pancreatic Neuroendocrine Neoplasms: Recent Advances and Controversies

Treatment of Neuroendocrine Neoplasms with Radiolabeled Peptides—Where Are We Now

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