The Safety and Efficacy of Peptide Receptor Radionuclide Therapy for Gastro-Entero-Pancreatic Neuroendocrine Tumors: A Single Center Experience

Curr Oncol. 2024 Sep 18;31(9):5617-5629. doi: 10.3390/curroncol31090416.

Abstract

The aim of the present study was to evaluate the safety and efficacy of radionuclide therapy with [177Lu]Lu-DOTA-TATE according to our single center experience at the University of Naples Federico II. For the present analysis, we considered 21 patients with progressive, advanced, well-differentiated G1 and G2 in patients with gastro-entero-pancreatic (GEP) neuroendocrine tumors (NETs) treated with [177Lu]Lu-DOTA-TATE according to the decisions of a multidisciplinary team. All patients underwent four cycles of 7-8 GBq of [177Lu]Lu-DOTA-TATE every 8 weeks. A whole-body scan (WBS) was performed 4, 48, and 168 h after each treatment. The dosimetry towards the organ at risk and target lesions was calculated. For each patient, renal and bone marrow parameters were evaluated before, during, and 3 months after the end of the treatment. Follow-up data were obtained and RECIST criteria were considered as the endpoint. Among 21 patients enrolled (mean age 65 ± 9 years); 17 (81%) were men and the small intestine was the most frequent location of disease (n = 12). A mild albeit significant variation (p < 0.05) in both platelets and white blood cell counts among all time points was observed, despite it disappearing 3 months after the end of the therapy. According to the RECIST criteria, 11 (55%) patients had a partial response to therapy and 8 (40%) had stable disease. Only one (5%) patient had disease progression 4 months after treatment. Our data confirm that [177Lu]Lu-DOTA is safe and effective in controlling the burden disease of G1/G2 GEP-NETs patients.

Keywords: [177Lu]Lu-DOTA-TATE; dosimetry; gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs); multidisciplinary team; peptide receptor radionuclide therapy (PRRT).

MeSH terms

  • Aged
  • Female
  • Humans
  • Intestinal Neoplasms* / radiotherapy
  • Male
  • Middle Aged
  • Neuroendocrine Tumors* / radiotherapy
  • Octreotide* / analogs & derivatives
  • Octreotide* / therapeutic use
  • Organometallic Compounds / therapeutic use
  • Pancreatic Neoplasms* / radiotherapy
  • Radiopharmaceuticals / therapeutic use
  • Receptors, Peptide / therapeutic use
  • Stomach Neoplasms* / radiotherapy
  • Treatment Outcome

Substances

  • Octreotide
  • Organometallic Compounds
  • Receptors, Peptide
  • lutetium Lu 177 dotatate
  • Radiopharmaceuticals

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor

Grants and funding

This research received no external funding.