Towards tailored radiopeptide therapy.

Abstract

PURPOSE:

Somatostatin receptor-targeted radiopeptide therapy is commonly performed using single radioisotopes. We evaluated the benefits and harms of combining radioisotopes in radiopeptide therapy in patients with neuroendocrine tumor.

METHODS:

Using multivariable-adjusted survival analyses and competing risk analyses we evaluated outcomes in patients with neuroendocrine tumor receiving (90)Y-DOTATOC, (177)Lu-DOTATOC or their combination.

RESULTS:

(90)Y-DOTATOC plus (177)Lu-DOTATOC treatment was associated with longer survival than (90)Y-DOTATOC (66.1 vs. 47.5 months; n = 1,358; p < 0.001) or (177)Lu-DOTATOC alone (66.1 vs. 45.5 months; n = 390; p < 0.001). (177)Lu-DOTATOC was associated with longer survival than (90)Y-DOTATOC in patients with solitary lesions (HR 0.3, range 0.1 - 0.7; n = 153; p = 0.005), extrahepatic metastases (HR 0.5, range 0.3 - 0.9; n = 256; p = 0.029) and metastases with low uptake (HR 0.1, range 0.05 - 0.4; n = 113; p = 0.001). (90)Y-DOTATOC induced higher hematotoxicity rates than combined treatment (9.5% vs. 4.0%, p = 0.005) or (177)Lu-DOTATOC (9.5 vs. 1.4%, p = 0.002). Renal toxicity was similar among the treatments.

CONCLUSIONS:

Using (90)Y and (177)Lu might facilitate tailoring radiopeptide therapy and improve survival in patients with neuroendocrine tumors.

• Authors: Piotr Radojewski, Rebecca Dumont, Nicolas Marincek, Philippe Brunner, Helmut R Mäcke, Jan Müller-Brand, Matthias Briel, Martin A Walter
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 42 Issue 8 Pg. 1231-7 (Jul 2015) ISSN: 1619-7089 [Electronic] Germany
• PMID: 25792454 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• 177Lu-octreotide, DOTA(0)-Tyr(3)-
• Radiopharmaceuticals
• 90Y-octreotide, DOTA-Tyr(3)-
• Octreotide

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Middle Aged
• Neuroendocrine Tumors (radiotherapy)
• Octreotide (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Radiopharmaceuticals (administration & dosage, adverse effects, therapeutic use)
• Survival Analysis