Prognostic Significance of Somatostatin Receptor Heterogeneity in Progressive Neuroendocrine Tumor Treated with Lu-177 DOTATOC or Lu-177 DOTATATE

Graf, Josephine; Pape, Ulrich‐Frank; Jann, Henning; Denecke, Timm; Arsenić, Ruža; Brenner, Winfried; Pavel, Marianne; Prasad, Vikas

doi:10.1007/s00259-019-04439-9

Cited by 54 publications

(70 citation statements)

References 44 publications

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“…Because these represented distinct tumor types from the GEP and lung NETs that comprised most other studies, this study was not included in further analyses [21]. One study, by Graf et al, compared heterogeneous versus homogenous SSTR expression but did not clearly define a PRRT re-treatment group; therefore, this study was not included in further analyses [22]. Finally, the patient population of Van Essen et al overlapped with the patient population described by Van der Zwan et al [7,23]; therefore, Van Essen et al was excluded from further analyses [7,23].…”

Section: Systematic Literature Reviewmentioning

confidence: 99%

“…Nine of 13 studies included in the feasibility assessment were retrospective cohort studies, three prospective single-arm trials were included, and one study (congress abstract) did not report the type of study (no randomized controlled trials were identified) (Table S1) [6][7][8][15][16][17][20][21][22][24][25][26][27][28][29]. The included studies comprised a range of 5-168 patients who received PRRT re-treatment.…”

Section: Feasibilitymentioning

confidence: 99%

“…The included studies comprised a range of 5-168 patients who received PRRT re-treatment. Inclusion criteria were mostly comparable across the 13 studies included in the feasibility assessment (Table S2) [6][7][8][15][16][17][20][21][22][24][25][26][27][28][29]. The efficacy and safety outcomes reported across studies varied considerably with some overlap (Table S1) [7,21,22,[24][25][26][27][28][29].…”

Section: Feasibilitymentioning

confidence: 99%

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Peptide receptor radiotherapy re-treatment in patients with progressive neuroendocrine tumors: A systematic review and meta-analysis

Strosberg

Leeuwenkamp

Siddiqui

2021

Cancer Treatment Reviews

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Background: This review and meta-analysis examined published evidence of peptide receptor radionuclide therapy (PRRT) re-treatment efficacy and safety in patients with advanced neuroendocrine tumors (NETs). Methods: Embase, MEDLINE, MEDLINE In-Progress, and Cochrane CENTRAL were searched (database inception-present) to identify evidence of efficacy and safety of PRRT re-treatment in adults with NETs previously treated with 177 Lu-and/or 90 Y-PRRT. Progression-free survival (PFS), overall survival (OS), disease control rate (DCR) from time of re-treatment were assessed. Data were pooled using medians and variance for time-to-event outcomes and inverse-variance weighted proportions (Freeman-Tukey method) for binary outcomes. Results: Of 567 studies screened, 13 reported re-treatment efficacy outcomes. In random-effects meta-analyses of 177 Lu-PRRT re-treatment, median PFS (N = 7 studies [414 patients]) was 12.52 months (95% CI 9.82-15.22) with moderate heterogeneity across studies (I 2 = 50.5%), median OS (N = 2 [194 patients]) was 26.78 months (95% CI 18.73-34.83) with moderate-to-high heterogeneity (I 2 = 57.5%), and DCR (N = 8 [347 patients]) was 71% (95% CI 66-75) with high heterogeneity (I 2 = 81.5%). PFS was similar with either 177 Lu-PRRT re-treatment alone or in combination with 90 Y-PRRT. Grade 3/4 adverse events occurred in 5% (95% CI 2-8) of patients receiving 177 Lu-PRRT re-treatment (N = 5 [271 patients]) with few grade 3/4 renal toxicities (0% [95% CI 0-1]). Pooled myelodysplastic syndrome and acute myeloid leukemia incidence was 0% (95% CI 0-2). Conclusion: Re-treatment with 177 Lu-PRRT provided encouraging median PFS in patients with NETs with a safety profile similar to initial PRRT.

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Section: Systematic Literature Reviewmentioning

confidence: 99%

Section: Feasibilitymentioning

confidence: 99%

Section: Feasibilitymentioning

confidence: 99%

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Peptide receptor radiotherapy re-treatment in patients with progressive neuroendocrine tumors: A systematic review and meta-analysis

Strosberg

Leeuwenkamp

Siddiqui

2021

Cancer Treatment Reviews

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“…Somatostatin receptor expressing tumor volume (SRETV), defined as tumor volume with higher [ 68 Ga]Ga-SST uptake than 50% of SUV max within the volume of interest for each lesion, demonstrated prognostic value of survival [103]. Visual assessment of SSTR heterogeneity on [ 68 Ga]Ga-SST PET/CT images was found valuable for prediction and prognosis with heterogeneity leading to lower survival, even though it is difficult to quantify ( Figure 3) [104]. [ 68 Ga]Ga-SST PET uptake heterogeneity determined based on intratumoral textural features predicted endoradiotherapy outcome more accurately than SUV max [105].…”

Section: Impact Of Sst Radiopharmaceuticals On Patient Treatment Manamentioning

confidence: 99%

“…This patient was characterized as heterogeneous as more than 50% of the target lesions showed heterogeneous somatostatin receptor (SSTR) expression. Reproduced from[104].Pharmaceuticals 2020, 13, x FOR PEER REVIEW 5 of 25…”

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confidence: 99%

(Radio)Theranostic Patient Management in Oncology Exemplified by Neuroendocrine Neoplasms, Prostate Cancer, and Breast Cancer

Velikyan

2020

Pharmaceuticals

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The role of nuclear medicine in the management of oncological patients has expanded during last two decades. The number of radiopharmaceuticals contributing to the realization of theranostics/radiotheranostics in the context of personalized medicine is increasing. This review is focused on the examples of targeted (radio)pharmaceuticals for the imaging and therapy of neuroendocrine neoplasms (NENs), prostate cancer, and breast cancer. These examples strongly demonstrate the tendency of nuclear medicine development towards personalized medicine.

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Imaging and liquid biopsy in the prediction and evaluation of response to PRRT in neuroendocrine tumors: implications for patient management

Roll

Weckesser

Seifert

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose The aim of this narrative review is to give an overview on current and emerging imaging methods and liquid biopsy for prediction and evaluation of response to PRRT. Current limitations and new perspectives, including artificial intelligence, are discussed. Methods A literature review of PubMed/Medline was performed with representative keywords. The search included articles published online through August 31, 2020. All searches were restricted to English language manuscripts. Results Peptide radio receptor therapy (PRRT) is a prospectively evaluated and approved therapy option in neuroendocrine tumors (NETs). Different ligands targeting the somatostatin receptor (SSTR) are used as theranostic pairs for imaging NET and for PRRT. Response assessment in prospective trials often relies on the morphological RECIST 1.1 criteria, based on lesion size in CT or MRI. The role of SSTR-PET and quantitative uptake parameters and volumetric data is still not defined. Monoanalyte tumor marker chromogranin A has a limited value for response assessment after PRRT. New emerging liquid biopsy techniques are offering prediction of response to PRRT and prognostic value. Conclusions New response criteria for NET patients undergoing PRRT will comprise multiparametric hybrid imaging and blood-based multianalyte markers. This represents tumor biology and heterogeneity.

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Prognostic Significance of Somatostatin Receptor Heterogeneity in Progressive Neuroendocrine Tumor Treated with Lu-177 DOTATOC or Lu-177 DOTATATE

Cited by 54 publications

References 44 publications

Peptide receptor radiotherapy re-treatment in patients with progressive neuroendocrine tumors: A systematic review and meta-analysis

Peptide receptor radiotherapy re-treatment in patients with progressive neuroendocrine tumors: A systematic review and meta-analysis

(Radio)Theranostic Patient Management in Oncology Exemplified by Neuroendocrine Neoplasms, Prostate Cancer, and Breast Cancer

Imaging and liquid biopsy in the prediction and evaluation of response to PRRT in neuroendocrine tumors: implications for patient management

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