Highly favourable outcomes with peptide receptor radionuclide therapy (PRRT) for metastatic rectal neuroendocrine neoplasia (NEN)

Favorable Outcome in Patients with Pheochromocytoma and Paraganglioma Treated with 177Lu-DOTATATE

“…We observed a median OS of 49.6 (range 8.2–139) months and a median PFS of 21.6 (range 6.7–138) months. Corresponding to two recently published 177 Lu-DOTATATE studies in small groups of PCC/PGL patients, we had similar duration of follow-up, median 32 (8–139) months, in comparison to the publication by Kong et al [14] reporting 28 (range 5–74) months follow-up for 14 patients and Yadav et al [15] who followed 25 patients median 30 (15–96) months after PRRT combined with 1250 mg/m 2 capecitabine (days 0 to 14 of each cycle). Our follow-up, however, allowed for the calculation of OS, whereas median OS was not reached in the other studies [14,15].…”

“…The median PFS 39 months, in the study by Kong et al and 32 months PFS reported by Yadav et al were both, however, longer than in the present study (21.6 months). Disease control (PR + SD) according to RECIST 1.1. was achieved in all of our patients as compared to 21/25 (84%) patients and 12/14 (86%) in the two previous reports [14,15], and notably, 11 of our patients were still alive at the time of evaluation. Four of our patients were progression-free between 9 and 138 months.…”

“…However, they also experienced 4/20 (20%) patients with grade 3 lymphopenia. Renal impairment in two of their patients was considered attributed to underlying disease processes [14]. In the larger study by Demirci et al, in 186 patients with mixed NET types, toxicity data for the subgroup of 12 patients with PCC/PGL are not reported.…”

“…Predominantly, 177 Lu-DOTATATE has been utilized, but also 90 Y-DOTATOC, with favorable results in NETs [9,10,11]. Furthermore, encouraging results of PRRT have been shown in small cohorts of PCC/PGL patients treated with 90 Y- DOTATOC [9,12] and with 177 Lu-DOTATATE [13,14,15,16]. In one study, 20 patients received 177 Lu-DOTATATE, of whom nine also underwent concomitant chemotherapy with fluorouracil as a radiosensitizer, which in 14 evaluable patients (RECIST 1.1) resulted in disease control ((partial response (PR) + stable disease (SD)) in 12/14 (86%) patients with 39 months median OS [14].…”

“…Furthermore, encouraging results of PRRT have been shown in small cohorts of PCC/PGL patients treated with 90 Y- DOTATOC [9,12] and with 177 Lu-DOTATATE [13,14,15,16]. In one study, 20 patients received 177 Lu-DOTATATE, of whom nine also underwent concomitant chemotherapy with fluorouracil as a radiosensitizer, which in 14 evaluable patients (RECIST 1.1) resulted in disease control ((partial response (PR) + stable disease (SD)) in 12/14 (86%) patients with 39 months median OS [14]. In a second study, 177 Lu-DOTATATE was combined with capecitabine in 25 patients and in 21 evaluable patients achieving disease control, that is, 21/25 (84%) patients, with median 32 months PFS [15].…”