¹¹¹In-DTPA⁰-octreotide (Octreoscan), ¹³¹I-MIBG and other agents for radionuclide therapy of NETs

Eur J Nucl Med Mol Imaging. 2012 Feb:39 Suppl 1:S113-25. doi: 10.1007/s00259-011-2013-8.

Abstract

This paper is a critical review of the literature on NET radionuclide therapy with (111)In-DTPA(0)-octreotide (Octreoscan) and (131)I-MIBG, focusing on efficacy and toxicity. Some potential future applications and new candidate therapeutic agents are also mentioned. Octreoscan has been a pioneering agent for somatostatin receptor radionuclide therapy. It has achieved symptomatic responses and disease stabilization, but it is now outperformed by the corresponding β-emitter agents (177)Lu-DOTATATE and (90)Y-DOTATOC. (131)I-MIBG is the radionuclide therapy of choice for inoperable or metastatic phaeochromocytomas/paragangliomas, which avidly concentrate this tracer via the noradrenaline transporter. Symptomatic, biochemical and tumour morphological response rates of 50-89%, 45-74% and 27-47%, respectively, have been reported. (131)I-MIBG is a second-line radiopharmaceutical for treatment of enterochromaffin carcinoids, mainly offering the benefit of amelioration of hormone-induced symptoms. High specific activity, non-carrier-added (131)I-MIBG and meta-astato((211)At)-benzylguanidine (MABG) are tracers with potential for enhanced therapeutic efficacy, yet their integration into clinical practice awaits further exploration. Amongst other promising agents, radiolabelled exendin analogues show potential for imaging and possibly therapy of insulinomas, while preclinical studies are currently evaluating DOTA peptides targeting the CCK-2/gastrin receptors that are overexpressed by medullary thyroid carcinoma cells.

Publication types

  • Review

MeSH terms

  • 3-Iodobenzylguanidine / adverse effects
  • 3-Iodobenzylguanidine / therapeutic use*
  • Carcinoid Tumor / radiotherapy
  • Carcinoma, Neuroendocrine
  • Humans
  • Iodine Radioisotopes / adverse effects
  • Iodine Radioisotopes / therapeutic use*
  • Neuroendocrine Tumors / metabolism
  • Neuroendocrine Tumors / radiotherapy*
  • Octreotide / adverse effects
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use
  • Paraganglioma / radiotherapy
  • Pentetic Acid / adverse effects
  • Pentetic Acid / analogs & derivatives*
  • Pentetic Acid / therapeutic use
  • Pheochromocytoma / radiotherapy
  • Radiopharmaceuticals / adverse effects
  • Radiopharmaceuticals / therapeutic use*
  • Receptors, Somatostatin / metabolism
  • Thyroid Neoplasms / radiotherapy

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Receptors, Somatostatin
  • SDZ 215-811
  • 3-Iodobenzylguanidine
  • Pentetic Acid
  • Octreotide

Supplementary concepts

  • Thyroid cancer, medullary