Polish Experience in Peptide Receptor Radionuclide Therapy

Abstract

The results indicate that PRRT with the procedures and isotopes used is an effective and safe therapy option for patients with metastatic or inoperable neuroendocrine tumors (NETs). Our results suggest that tandem therapy with (90)Y/(177)Lu-DOTATATE provides longer overall survival than single-isotope treatment. Hematological toxicity was rare in all treated patients. Renal toxicity grade 3 and 4 was observed only in the group treated with (90)Y-DOTATATE.

Zalecenia ogólne dotyczące postępowania w nowotworach neuroendokrynnych układu pokarmowego (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

“…90 Y, or a combination of the two. Data from nonrandomised clinical studies indicates that a response to treatment (complete or partial remission) can be achieved in approximately 8-46% of patients, and the mean progression-free survival after the treatment is 25 to 36 months [133][134][135][136][137][138][139][140][141]. These studies apply mostly to patients with well-differentiated neoplasms (G1 and G2), and these recommendations are for this group of patients.…”

“…This therapy should not be discontinued during isotope treatment; however, it would be best if the interval between administrations of a long-acting analogue was 4-7 weeks. If the treatment with a SSA needs to be continued, short-acting analogues are recommended [140].…”

Nowotwory neuroendokrynne jelita grubego — zasady postępowania (rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

“…Taking into account the high degree of effectiveness of PRRT in other GEP NENs, PRRT should be considered in patients with disseminated or non-surgical NENs G1, G2, with increased somatostatin receptor expression confirmed in the scintigraphic examination, if other available treatment methods prove ineffective [36][37][38][39][40][41][42][43][44][45][46].…”

Nowotwory neuroendokrynne żołądka i dwunastnicy z uwzględnieniem gastrinoma (zasady postępowania rekomendowane przez Polską Sieć Guzów Neuroendokrynnych)

“…Both in gastric NETs of type 3 and duodenal NETs, PRRT may be used in advanced, non-resectable, progressive processed cases, after the failure of previous treatment [79][80][81]. This treatment may be conducted in the case of the confirmed high expression of somatostatin receptors (SSTR) on the tumour cells in an SRI examination, and when there are no contraindications for this type of therapy [79][80][81][82][83][84]. Early radioisotope diagnostics allow the determination of the advancement of the neoplastic process, and eligibility for the treatment with radioisotope-labelled somatostatin analogues.…”