The efficacy of 177Lu-labelled peptide receptor radionuclide therapy in patients with neuroendocrine tumours: a meta-analysis

Kim, Seong-Jang; Pak, Kyoungjune; Koo, Phillip J.; Kwak, Jennifer; Chang, Sun Ju

doi:10.1007/s00259-015-3155-x

Cited by 76 publications

(39 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The group also found that persistent toxicity was associated with a shorter duration of PRRT from the first to the last cycle and that nephrotoxicity was more likely to occur in patients treated with Y-90-based PRRT either alone or in combination with Lu-177-DOTATATE. [ 3 20 21 ] We similarly found that the most important side effects were related to bone marrow suppression with the most pronounced effect noted on the platelet count.…”

Section: Discussionmentioning

confidence: 64%

See 1 more Smart Citation

First results and experience with PRRT in South Africa

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 64%

“…[ 24 ] What is clear is that the results of PRRT in our center are comparable with those results published from other centers in Europe. [ 19 20 21 ]…”

Section: Discussionmentioning

confidence: 99%

First results and experience with PRRT in South Africa

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Greater harmonisation of guidelines and treatment protocols is also a challenge with radioligand therapy, causing inconsistencies in practice. As the evidence base evolves, both guidelines and models of care need to be updated in line with the latest scientific advances [16,17].…”

Section: Unclear Models Of Carementioning

confidence: 99%

Realising the potential of radioligand therapy: policy solutions for the barriers to implementation across Europe

Merkel

Whicher

Bomanji³

et al. 2020

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

BackgroundThe use of targeted radiation with radioisotopes has been applied for decades in thyroid cancer. However, the use of radioligand therapy-also referred to as peptide-receptor radionuclide therapy (PRRT), systemic radiation therapy, targeted radionuclide therapy (TRT), targeted radiotherapy or molecular radiotherapy-is now gaining ground more broadly in oncology. Therapies have been approved for a small number of cancers where few treatment options exist, such as midgut neuroendocrine tumours and metastatic castration-resistant prostate cancer (mCRPC) [1, 2], and they have been shown to improve progression-free survival and quality of life for many patients [3][4][5][6][7]. The approach is also being explored in other cancer and non-cancer conditions.Nuclear medicine has, traditionally, sat somewhat on the sidelines of cancer care; however, the evolving oncology landscape suggests its role will grow, with broader applications in both diagnostics and therapy [8]. Nuclear medicine specialists will need to be fully integrated into multidisciplinary cancer care teams, and appropriate resourcing to deliver radioligand therapy-in terms of hospital infrastructure and workforce, as well as nuclear waste facilities-will need to be taken into account in future cancer plans and care pathways.Over the course of 2019, we conducted desk research and semi-structured expert interviews to explore potential barriers to achieving this integration in practice, drawing on insights from five different countries-Germany, Italy, Poland, Spain and the United Kingdom. The resulting document, 'Radioligand therapy: realising the potential of targeted cancer care', [9] was launched at the European Parliament in January 2020 along with an accompanying video explaining radioligand therapy for a lay audience. This report is an important reminder to the fields of nuclear medicine and oncology of the factors necessary to ensure advances in nuclear medicine reach patients in future models of cancer care.What are the potential barriers to integration of radioligand therapy into cancer care?Healthcare systems are often inadequately prepared for greater utilisation and integration of radioligand therapy. The report identified six key barriers to the greater integration of radioligand therapy into cancer care: low awareness and understanding; limited professional capacity, training and workforce planning; unclear models of care; inadequate physical capacity and resourcing in hospitals; evolving legislation, regulation and policy; and lack of data and research [9].

show abstract

“…PRRT will not be generally discussed in this review, however, it is receiving much attention as a therapeutic, targeted approach for patients with advanced NETs, and thus plays a role in the utilization of SRS, to assess whether this approach might be considered, by establishing the presence of somatostatin receptors on NET tissue [30, 32, 35, 41••, 42]. A recent prospective, randomized clinical trial (NETTER)[ 43•] using 177 Lu-DOTATATE in patients with unresectable advanced ileal NETs has been reported in preliminary communications to be effective with an acceptable safety profile.…”

Section: Molecular Imaging Of Neuroendocrine Tumorsmentioning

confidence: 99%

Molecular imaging in neuroendocrine tumors: recent advances, controversies, unresolved issues, and roles in management

Ito¹,

Jensen²

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

View full text Add to dashboard Cite

Purpose To review recent advances in molecular imaging of neuroendocrine tumors (NETs), discuss unresolved issues, and review how these advances are affecting clinical management. Recent findings Molecular imaging of NETs underwent a number of important changes in the last few years, leading to some controversies, unresolved issues, and significant changes in clinical management. The most recent changes are reviewed in this article. Particularly important is the rapid replacement in somatostatin receptor scintigraphy (SRS) of 111In-DTPA-SPECT/CT by 68Ga-DOTA-peptide-PET/CT imaging, which is now approved in many countries including the US. Numerous studies in many different types of NETs demonstrate the greater sensitivity of 68Ga-DOTA-peptide-PET/CT, its high specificity, and its impact on management. Other important developments in SRS/molecular imaging include demonstrating the prognostic value of both 68Ga-DOTA-peptide-PET/CT and 18F-FDG –PET/CT; how their use can be complementary; comparing the sensitivities and usefulness of 68Ga-DOTA-peptide-PET/CT and 18F-FDOPA PET/CT; introducing new linkers and radiolabeled ligands such as 64Cu-DOTA-peptides with a long half-life, enhancing utility; and the introduction of somatostatin receptor antagonists which show enhanced uptake by NETs. In addition, novel ligands which interact with other receptors (GLP1, Bombesin, CCK, GIP, integrin, chemokines) are described which show promise in the imaging of both NETs and other tumors. Summary Molecular imaging is now required for all aspects of the management of patients with NETs. It results are essential not only for the proper diagnostic management of the patient, but also for assessing whether the patient is a candidate for peptide receptor radionuclide therapy (PRRT) with 177Lu and also for providing prognostic value.

show abstract

The efficacy of 177Lu-labelled peptide receptor radionuclide therapy in patients with neuroendocrine tumours: a meta-analysis

Abstract: (177)Lu-labelled PRRT is an effective treatment option for patients with inoperable or metastatic NETs.

Cited by 76 publications

References 27 publications

First results and experience with PRRT in South Africa

First results and experience with PRRT in South Africa

Realising the potential of radioligand therapy: policy solutions for the barriers to implementation across Europe

Molecular imaging in neuroendocrine tumors: recent advances, controversies, unresolved issues, and roles in management

Contact Info

Product

Resources

About