Survival and Response Outcomes for Gastrointestinal Neuroendocrine Tumor (GEP-NETs) Patients Treated with Lutetium—177-DOTATATE in a Brazilian Reference Center: A Six-Year Follow-Up Experience

Abstract

Background: PRRT can be an option for all-grade GEP-NETs, but selecting patients is challenging. In this scenario, clinical-pathological and radiological characteristics, such as pre-treatment Ga-68 DOTA PET/CT, might have the potential to help. Methods: A retrospective chart review was conducted on advanced GEP-NETs treated with at least one PRRT dose. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan–Meier method. Krenning Score (KS), and the maximum standardized uptake value (SUVmax) were derived from the pre-treatment scans. A maximally selected rank statistics test was used for SUVmax simple cut point estimate. Results: Among 36 patients, 19 had primary pancreatic tumors. The numbers of G1, G2, and G3 tumors were 10, 18, and 7, respectively. During a median follow-up of 90.5 months, 4 patients died. Median OS was not reached for G1 and G2 tumors, and it was 30 months for G3 (p = 0.001). Median PFS was 23 months, with G3 showing lower PFS compared to G1 [7 versus 30 months; HR 8.41 (95%CI 2.2–31.0; p = 0.001)]. Conclusions: PRRT provides long-term PFS in patients with G1/G2 GEP-NETs independent of clinical characteristics and primary site. G3 has worse survival, but selected patients may experience long OS after PRRT treatment.

Radionuclide Theranostics in Neuroendocrine Neoplasms: An Update

“…They treated 143 patients with advanced NET, administering ~ 8 GBq for 4 cycles every 8 weeks, and observed a median PFS of 32.3 months, a median OS of 72.5 months, and no evidence of renal toxicity, while MDS occurred in 5% of the subjects [ 13 ]. Favorable results were also reported in Brazilian ( n = 36; mPFS = 23.0; OS = 30.0 months for G3 patients) [ 14 ], Polish ( n = 167; mPFS = 29.3; OS = 34.0 months) [ 15 ], and Korean ( n = 64; mPFS = 21.7; OS not reached within the 15.7-month follow-up) [ 16 ] cohorts.…”