Treatment with tandem [90Y]DOTA-TATE and [177Lu]DOTA-TATE of neuroendocrine tumours refractory to conventional therapy

Treatment with tandem [90Y]DOTA-TATE and [177Lu]DOTA-TATE of neuroendocrine tumours refractory to conventional therapy

Purpose Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues has been demonstrated to be an effective therapeutic option in patients with disseminated neuroendocrine tumours (NET). Treatment with tandem [ 90 Y]DOTA-TATE and [ 177 Lu]DOTA-TATE may improve the efficac...

Full description

Saved in:
Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2014-02, Vol.41 (2), p.223-230
Main Authors: Seregni, E., Maccauro, M., Chiesa, C., Mariani, L., Pascali, C., Mazzaferro, V., De Braud, F., Buzzoni, R., Milione, M., Lorenzoni, A., Bogni, A., Coliva, A., Vullo, S. Lo, Bombardieri, E.
Format: Article
Language:eng
Subjects:
Adult
Aged
Cardiology
Drug Resistance, Neoplasm
Drug therapy
Endocrine system
Female
Humans
Imaging
Male
Medicine
Medicine & Public Health
Metastases
Middle Aged
Neuroendocrine Tumors - drug therapy
Neuroendocrine Tumors - radiotherapy
Neurology
Nuclear Medicine
Octreotide - adverse effects
Octreotide - analogs & derivatives
Octreotide - therapeutic use
Oncology
Organometallic Compounds - adverse effects
Organometallic Compounds - therapeutic use
Original Article
Orthopedics
Radiology
Radiometry
Radiopharmaceuticals - adverse effects
Radiopharmaceuticals - therapeutic use
Treatment Outcome
Tumors
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues has been demonstrated to be an effective therapeutic option in patients with disseminated neuroendocrine tumours (NET). Treatment with tandem [ 90 Y]DOTA-TATE and [ 177 Lu]DOTA-TATE may improve the efficacy of PRRT without increasing the toxicity. In a phase II study we evaluated the feasibility of combined PPRT with a high-energy beta emitter ( 90 Y) and a medium-energy beta/gamma emitter ( 177 Lu) in patients with metastatic NET refractory to conventional therapy. Methods A group of 26 patients with metastatic NET were treated with four therapeutic cycles of alternating [ 177 Lu]DOTA-TATE (5.55 GBq) and [ 90 Y]DOTA-TATE (2.6 GBq). A dosimetric evaluation was carried out after administration of [ 177 Lu]DOTA-TATE to calculate the absorbed doses in healthy organs. The acute and long-term toxicities of repeated treatment were analysed. PRRT efficacy was evaluated according to RECIST. Results Administration of tandem [ 90 Y]DOTA-TATE and [ 177 Lu]DOTA-TATE induced objective responses in 42.3 % of patients with metastatic NET with a median progression-free survival longer than 24 months. Of patients with pretreatment carcinoid syndrome, 90 % showed a symptomatic response or a reduction in tumour-associated pain. The cumulative biologically effective doses (BED) were below the toxicity limit in the majority of patients, in the absence of renal function impairment Conclusion The results of our study indicates that combined [ 90 Y]DOTA-TATE and [ 177 Lu]DOTA-TATE therapy is a feasible and effective therapeutic option in NET refractory to conventional therapy. Furthermore, the absence of kidney damage and the evaluated cumulative BEDs suggest that increasing the number of tandem administrations is an interesting approach.
ISSN:1619-7070
1619-7089