Tumour-to-liver ratio determined by [68Ga]Ga-DOTA-TOC PET/CT as a prognostic factor of lanreotide efficacy for patients with well-differentiated gastroenteropancreatic-neuroendocrine tumours

Abstract

Background: Lanreotide is a long-acting somatostatin analogue with proven antitumour effects against well-differentiated (WD) gastroenteropancreatic-neuroendocrine tumours (GEP-NETs). However, there are no globally established prognostic factors associated with the efficacy of lanreotide as a treatment for GEP-NETs. We investigated the prognostic value of [ 68 Ga]Ga-DOTA-TOC positron emission tomography (PET)/computed tomography (CT) somatostatin receptor imaging for patients with WD GEP-NETs treated with lanreotide. Methods: In this retrospective study, we included 31 patients with unresectable or metastatic WD GEP-NETs who received lanreotide and underwent [ 68 Ga]Ga-DOTA-TOC PET/CT before receiving lanreotide. We captured the following clinicopathological variables: Eastern Cooperative Oncology Group (ECOG) performance status, primary tumour site, NET World Health Organization grade, existence of carcinoid symptoms, previous surgery, previous chemotherapy, and hepatic tumour volume assessed by CT or magnetic resonance imaging (MRI). We also assessed the following [ 68 Ga]Ga-DOTA-TOC PET/CT variables: Krenning score, tumour-to-liver ratio (TLR), maximum standardized uptake value (SUVmax), whole tumour volume (WTV), and total receptor expression (TRE, WTV multiplied by SUVmean). The associations between these markers and progression-free survival (PFS) with lanreotide were analysed.

Capecitabine plus temozolomide in patients with grade 3 unresectable or metastatic gastroenteropancreatic neuroendocrine neoplasms with Ki-67 index <55%: single-arm phase II study

“…In this study, correlation analysis between nuclear imaging findings and efficacy outcomes was not preplanned. Considering the potential relevance of nuclear imaging in predicting the prognosis of patients with GEP-NETs, 19 post hoc analysis was carried out for patients who underwent nuclear imaging (Gallium 68-DOTATOC [ 68 Ga-DOTATOC] and/or 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) before treatment. Briefly, 68 Ga-DOTATOC and 18 F-FDG PET/CT images from the vertex to the upper thigh were acquired approximately 60 min after intravenous administration of 68 Ga-DOTATOC 148 MBq (4 mCi) and 18 F-FDG 0.14 mCi/kg, respectively (GE Discovery PET/CT 690, 690 Elite, or 710; GE Medical Systems, Milwaukee, WI).…”

Nuclear Medicine Imaging in Neuroblastoma: Current Status and New Developments

“…Second, [ 68 Ga]Ga-DOTA peptide uptake can have prognostic value. Low uptake has been shown to be an indicator of poor prognosis in adults with neuroendocrine tumors [92][93][94], but this has not been studied in neuroblastoma. Nevertheless, higher SSTR2 expression is correlated with higher [ 68 Ga]Ga-DOTATATE uptake [94].…”

Systemic Treatment of Advanced Gastroenteropancreatic Neuroendocrine Tumors in Korea: Literature Review and Expert Opinion

“…Other systemic therapeutic options such as targeted therapy or cytotoxic chemotherapy could be used for patients with a high Ki-67 index or high tumor volumes, but SSAs should not be precluded in these cases given their favorable toxicity profiles. 68 Ga-based SSTR targeting PET/CT may be helpful in predicting the efficacy outcomes of SSA treatments [16,20] 8 Korean Cancer Association This article is protected by copyright. All rights reserved.…”

“…Previous studies have shown that these gallium-based functional imaging methods are sensitive and deliver complementary information that is very useful for therapeutic decision-making [ 20 , 22 ]. 68 Ga-DOTA-TOC positron emission tomography (PET)/CT is available for use in Korea but is not currently reimbursed by the national health insurance system [ 23 ].…”