Radioembolization with selective internal radiation microspheres for neuroendocrine liver metastases

King, Julie; Quinn, Richard J.; Glenn, Derek; Janssen, Julia; Tong, Daochen; Liaw, Winston; Morris, David L.

doi:10.1002/cncr.23685

Cited by 249 publications

(151 citation statements)

References 83 publications

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“…King et al [9] treated 34 patients affected by hepatic NET with 90 Y radioembolization: symptomatic responses were registered in 50 % of the patients at 6 months post treatment, and the mean overall survival was 29.4±3.4 months. Two patients had biopsy-proven radiation gastritis, one died due to liver dysfunction and pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Filippi

Ciorra

Sardella

et al. 2014

Nucl Med Mol Imaging

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90 Y radioembolization and peptide-receptor radionuclide therapy (PRRT) with 177 Lu-DOTATATE are both effective treatments for patients with inoperable neuroendocrine metastatic tumors (NET). We report the case of a 72-year-old man with severe functional syndrome due to a metastatic NET. 68 Ga-DOTATOC positron-emission tomography (PET) revealed high somatostatin receptor expression in a gross liver metastasis, in one abdominal lymph node and in several s k e l e t a l l e s i o n s . T h e p a t i e n t u n d e r w e n t l i v e r radioembolization with 90 Y-resin microspheres followed by four cycles of PRRT with 177 Lu-DOTATATE. After 3 months, a complete remission of the functional syndrome was observed. 68 Ga-DOTATOC PET demonstrated a complete response for skeletal and lymph nodal lesions with a residual bulky mass in the liver. Therefore a further 90 Y radioembolization was performed as consolidation treatment for the hepatic lesion. Six months after these combined treatments, 68 Ga-DOTATOC PET demonstrated complete metabolic response in liver and stable extrahepatic lesions. No significant long-term adverse reactions were registered. To our knowledge, the sequential use of 90 Y radiembolization before and after PRRT in a liver-dominant advanced NET has not been reported in the literature and this case suggests that these combined treatments can be safe and effective.

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Section: Discussionmentioning

confidence: 99%

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Filippi

Ciorra

Sardella

et al. 2014

Nucl Med Mol Imaging

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“…The median survival from time of treatment was 70 months. Objective respond rate (complete and partial response) were observed in 50% of patients in a prospective studies, in which 32 patients were treated with 90 Y microspheres [25].…”

Section: Transarterial Embolization (Tae)/transarterial Chemoembolizamentioning

confidence: 99%

Long-term Survival in Patient with Metastatic Pancreatic Neuroendocrine Tumor Treated by Variable Treatment

Kang¹,

Ryu²,

Lee³

et al. 2017

Korean J Pancreas Biliary Tract

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Well-to-moderately differentiated neuroendocrine tumors of gastroesophageal and pancreatic origin (GEP-NETs) with liver metastasis are a heterogeneous group of malignancies for which a range of therapeutic options have been employed. Surgical resection of hepatic metastases or hepatic artery embolization may be beneficial in patients with hepatic-predominant metastatic disease. Patients with "carcinoid" syndrome and syndromes associated with functional pancreatic NET (PNET) can be effectively treated with somatostatin analogs. On the other hand, the efficacy of systemic chemotherapy for these patients is limited. A placebo-controlled, double-blind, prospective, and randomized study showed that octreotide LAR improves progression-free survival in patients with advanced midgut functional "carcinoids." In patients with advanced pancreatic NET, randomized, placebo-controlled studies have recently demonstrated that treatment with the tyrosine kinase inhibitor sunitinib or with mTOR inhibitor everolimus is associated with improved progression-free survival. Based on these studies, octreotide LAR, sunitinib, or everolimus are now considered as first-line therapeutic options in patients with advanced NET. Future studies will likely further define the role of these agents in patients with carcinoid liver metastasis and pancreatic NET liver metastasis.

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“…The experience with this technique is still in its infancy, especially in the setting of pNETs. However, early results are encouraging, showing a median survival of approximately 70 months and reporting stable lesions or partial response in 27 and 60.5 % of patients, respectively [79,80].…”

Section: Advanced Diseasementioning

confidence: 99%

Pancreatic Neuroendocrine Tumors: an Update

2015

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Pancreatic neuroendocrine tumors (pNETs) are rare and comprise only 1-2 % of all pancreatic neoplastic disease. Although the majority of these tumors are sporadic (90 %), pNETs can arise in the setting of several different hereditary genetic syndromes, most commonly multiple endocrine neoplasia type 1 (MEN1). The presentation of pNETs varies widely, with over 60 % having malignant distant disease at the time of initial diagnosis involving the liver or other distant sites. Functioning pNETs represent approximately 10 % of all pNETs, secrete a variety of peptide hormones, and are responsible for several clinical syndromes caused by profound hormonal derangement. Surgery remains the cornerstone of therapy and the only curative approach. It should be pursued for localized disease and for metastatic lesions amenable to resection. Multimodality therapies, including liver-directed therapies and medical therapy, are gaining increasing favor in the treatment of advanced pNETs. Their utility is multifold and spans from ameliorating symptoms of hormonal excess (functional pNETs) to controlling the local and systemic disease burden (non-functional pNETs). The recent introduction of target molecular therapy has promising results especially for the treatment of progressive well-differentiated G1/G2 tumor. In this review, we summarize the current knowledge and give an update on recent advancements made in the therapeutic strategies for pNETs.

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Radioembolization with selective internal radiation microspheres for neuroendocrine liver metastases

Cited by 249 publications

References 83 publications

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Sequential Use of 90Y Microspheres Radioembolization and 177Lu-Dotatate in Pluri-Metastatic Neuroendocrine Tumors: A Case Report

Long-term Survival in Patient with Metastatic Pancreatic Neuroendocrine Tumor Treated by Variable Treatment

Pancreatic Neuroendocrine Tumors: an Update

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