The impact of 177Lu-octreotide therapy on 99mTc-MAG3 clearance is not predictive for late nephropathy.

Abstract

Peptide Receptor Radionuclide Therapy (PRRT) for the treatment of neuroendocrine tumors may lead to kidney deterioration. This study aimed to evaluate the suitability of 99mTc-mercaptoacetyltriglycine (99mTc--MAG3) clearance for the early detection of PRRT-induced changes on tubular extraction (TE). TE rate (TER) was measured prior to 128 PRRT cycles (7.6±0.4 GBq 177Lu-octreotate/octreotide each) in 32 patients. TER reduction during PRRT was corrected for age-related decrease and analyzed for the potential to predict loss of glomerular filtration (GF). The GF rate (GFR) as measure for renal function was derived from serum creatinine. The mean TER was 234 ± 53 ml/min/1.73 m² before PRRT (baseline) and 221 ± 45 ml/min/1.73 m² after a median follow-up of 370 days. The age-corrected decrease (mean: -3%, range: -27% to +19%) did not reach significance (p=0.09) but significantly correlated with the baseline TER (Spearman p=-0.62, p<0.001). Patients with low baseline TER showed an improved TER after PRRT, high decreases were only observed in individuals with high baseline TER. Pre-therapeutic TER data were inferior to plasma creatinine-derived GFR estimates in predicting late nephropathy. TER assessed by 99mTc-MAG3-clearance prior to and during PRRT is not suitable as early predictor of renal injury and an increased risk for late nephropathy.

• Authors: Rudolf A Werner, Seval Beykan, Takahiro Higuchi, Katharina Lückerath, Alexander Weich, Michael Scheurlen, Christina Bluemel, Ken Herrmann, Andreas K Buck, Michael Lassmann, Constantin Lapa, Heribert Hänscheid
• Journal: Oncotarget (Oncotarget) Vol. 7 Issue 27 Pg. 41233-41241 (Jul 05 2016) ISSN: 1949-2553 [Electronic] United States
• PMID: 27259246 (Publication Type: Journal Article)

Chemical References

• 177Lu-octreotate
• Technetium Tc 99m Mertiatide
• Octreotide

Topics

• Adult
• Aged
• Female
• Glomerular Filtration Rate (radiation effects)
• Humans
• Kidney Diseases (diagnosis, etiology)
• Kidney Tubules (metabolism, radiation effects)
• Male
• Middle Aged
• Neuroendocrine Tumors (diagnosis, metabolism, radiotherapy)
• Octreotide (adverse effects, analogs & derivatives, therapeutic use)
• Prognosis
• Radiation Injuries (diagnosis)
• Retrospective Studies
• Single Photon Emission Computed Tomography Computed Tomography
• Technetium Tc 99m Mertiatide (pharmacokinetics)
• Young Adult