Supportive Measures and Finer Practice Points in <sup>177</sup>Lu-DOTATATE PRRT for NET: Aiming for Optimal Disease Management

Basu, Sandip; Ostwal, Vikas; Ranade, Rohit; Panda, Dipanjan

doi:10.2967/jnumed.114.146282

Cited by 4 publications

(3 citation statements)

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“…Ondansetron (4–8 mg IV) and dexamethasone (4 mg IV) were administered as part of prophylaxis, and analgesics were prescribed and administered when needed. [ 9 ]…”

Section: Methodsmentioning

confidence: 99%

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First results and experience with PRRT in South Africa

et al. 2018

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Neuroendocrine tumors (NETs) are a diverse group of tumors that often present late due to nonspecific symptoms. These tumors frequently express somatostatin receptors (SSRs), which allows for positron emission tomography/computed tomography (PET/CT) imaging with Ga-68-DOTATATE. In eligible patients, this may then be followed by peptide receptor radionuclide therapy (PRRT). Here, we report our initial results and experience with PRRT in a developing country, as one of the first groups to provide this therapy in South Africa. Eligible patients with confirmed inoperable NETs were recruited prospectively and treated with Lu-177-DOTATATE. Baseline imaging was performed with either single-photon emission CT-or PET-based SSR analogs, whereas follow-up was performed with 68 Ga-DOTATATE PET/CT 6 months post treatment completion. Interim treatment response evaluation was based on post therapy imaging of Lu-177-DOTATATE. A total of 48 patients with a mean age of 58 years were treated with PRRT, of whom 22 (46%) demonstrated stable disease, 20 (42%) demonstrated a partial response, and 6 (12%) demonstrated progressive disease. The median progression-free survival (PFS) was 20 months with an interquartile range (IQR) 25%-75% of 4.5-30 months. The median freedom from progression duration was 32 months with an IQR 25%-75% of 25-40 months, and the median overall survival was 10 months with an (IQR) 25%-75% of 5-24 months. Our subgroup analysis demonstrated an inverse association between metabolic tumor volume with PFS, which requires further validation. In conclusion, PRRT with Lu-177-DOTATATE resulted in a median PFS of 20 months in patients with inoperable NETs in the absence of significant side effects.

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“…Ondansetron (4–8 mg IV) and dexamethasone (4 mg IV) were administered as part of prophylaxis, and analgesics were prescribed and administered when needed. [ 9 ]…”

Section: Methodsmentioning

confidence: 99%

“…[5,8] Ondansetron (4-8 mg IV) and dexamethasone (4 mg IV) were administered as part of prophylaxis, and analgesics were prescribed and administered when needed. [9] Patients were also provided with a diet tailored to the requirements of NET patients.…”

Section: Therapy Detailsmentioning

confidence: 99%

First results and experience with PRRT in South Africa

et al. 2018

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“…The patient preparation is quite important in these cases to prevent carcinoid crisis following PRRT (a rare but possible condition), which can be well obviated by good preparation. [30] In our setting, in a patient with symptomatic carcinoid syndrome, we advocate short-acting octreotide injections (subcutaneous) till 1 day before administering PRRT and start back the next day following PRRT and continue till 10-14 days after therapy. Furthermore, in a patient with bulky hepatic metastases, priming with antiserotonergic agent (e.g., cyproheptadine) is regularly undertaken.…”

Section: Resistant Functioning Neuroendocrine Neoplasm With Carcinoid Syndromementioning

confidence: 99%

Peptide Receptor Radionuclide Therapy in the Management of Neuroendocrine Tumors (Neoplasms): Fundamentals and Salient Clinical Practice Points for Medical Oncologists

Basu

Parghane

Ranade

et al. 2019

Indian Journal of Medical and Paediatric Oncology

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This editorial commentary is an expert summary of “Peptide Receptor Radionuclide Therapy (PRRT),” encompassing the essential fundamentals and salient clinical practice points, deliberated and designed in a point-wise manner with theme-based subheadings. Emphasis has been laid on the topics of practical relevance to the referring oncologists with relevant finer points where necessary. A part of the presented overview has been generated from the authors' own practical experience of more than 3500 successful therapies delivered over the last 9 years at a large tertiary care PRRT setting by the joint efforts of Radiation Medicine Centre (RMC), Bhabha Atomic Research Centre (BARC), and Gastrointestinal services of Tata Memorial Hospital (TMH) at the TMH-RMC premises. While the technical indigenization is beyond the scope of this treatise, we must mention here that India had been one of the frontrunners in this treatment modality, and the PRRT services in this country were developed purely as an indigenous effort right from the production of the radionuclide (177-Lutetium) at the reactor and radiolabeling and production of the radiopharmaceutical (177Lu-DOTATATE) by the radiopharmaceutical scientists at the BARC and RMC; such an endeavor allowed this very specialized therapy to be delivered at a very affordable cost in our setting which could be viewed as a major societal contribution of the atomic energy research in this country.

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Radionuclide Therapy in Neuroendocrine Tumors

Kabasakal

Demirci²,

Selçuk³

2022

Radionuclide Therapy

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Supportive Measures and Finer Practice Points in ¹⁷⁷Lu-DOTATATE PRRT for NET: Aiming for Optimal Disease Management

Cited by 4 publications

References 10 publications

First results and experience with PRRT in South Africa

First results and experience with PRRT in South Africa

Peptide Receptor Radionuclide Therapy in the Management of Neuroendocrine Tumors (Neoplasms): Fundamentals and Salient Clinical Practice Points for Medical Oncologists

Radionuclide Therapy in Neuroendocrine Tumors

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Supportive Measures and Finer Practice Points in 177Lu-DOTATATE PRRT for NET: Aiming for Optimal Disease Management

Cited by 4 publications

References 10 publications

First results and experience with PRRT in South Africa

First results and experience with PRRT in South Africa

Peptide Receptor Radionuclide Therapy in the Management of Neuroendocrine Tumors (Neoplasms): Fundamentals and Salient Clinical Practice Points for Medical Oncologists

Radionuclide Therapy in Neuroendocrine Tumors

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Product

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Supportive Measures and Finer Practice Points in ¹⁷⁷Lu-DOTATATE PRRT for NET: Aiming for Optimal Disease Management