177 Treatment of neuroendocrine tumours with 177 Lu‐Peptide Receptor Radionuclide Therapy: Challenging clinical scenarios and their management

Background: The incidence of pancreatic Neuroendocrine Tumours (pNETs) has increased considerably in the last few decades. The characteristic features of this tumour and the development of new investigative and therapeutic methods had a great impact on its management. Objective: The aim of this review is to investigate the outcome of Peptide Receptor Radionuclide Therapy (PRRT) in the treatment of pancreatic neuroendocrine tumours. Methods: A comprehensive literature search strategy was used based on two databases (SCOPUS, and PubMed). We considered all studies published in English, evaluating the use of PRRT (177Luteciuim- DOTA-conjugated peptides and 90Yetrium- DOTA- conjugated peptides) in the treatment of pancreatic neuroendocrine tumours as a standalone entity or as a subgroup within the wider category of Gastroenteropancreatic Neuroendocrine Tumours (GEP NETs). Results: PRRT was found to be an effective treatment modality as a monotherapy or in combination with other therapies in the treatment of non-operable and metastatic pNETs where other options are limited. Complete response was reported to be between 2-6% while partial response was achieved in up to 60% of cases. Survival analysis was also impressive. Progression Free Survival (PFS) reached a mean of 34 months and Overall Survival (OS) of 53 months. PRRT also proved to improve patients’ Quality of Life (QoL). Acute and sub-acute side effects like nephrotoxicity and haematotoxicity are usually mild and reversible. Conclusion: PRRT is well tolerated and effective treatment option for non-operable and/or metastatic pNETs. Side effects are usually mild and reversible. Larger randomized controlled trails need to be done to compare PRRT with other treatment modalities and to provide more detailed guidelines regarding patient selections, the choice of PRRT, follow up and response assessment to maximum potential benefit.

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Molecular profiling of neuroendocrine tumours to predict response and toxicity to peptide receptor radionuclide therapy

The Lancet Oncology ◽

10.1016/s1470-2045(20)30323-5 ◽

2020 ◽

Vol 21 (9) ◽

pp. e431-e443 ◽

Cited By ~ 1

Author(s):

Lisa Bodei ◽

Heiko Schöder ◽

Richard P Baum ◽

Ken Herrmann ◽

Jonathan Strosberg ◽

...

Keyword(s):

Radionuclide Therapy ◽

Neuroendocrine Tumours ◽

Peptide Receptor Radionuclide Therapy ◽

Molecular Profiling ◽

Peptide Receptor

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RADIONUCLIDE IMAGING AND THERAPY OF NEUROENDOCRINE TUMOURS

Journal of Cancer & Allied Specialties ◽

10.37029/jcas.v1i2.30 ◽

2015 ◽

Vol 1 (2) ◽

Author(s):

Shaunak Navalkissoor ◽

Gopinath Gnanasegaran

Keyword(s):

Radionuclide Imaging ◽

Radionuclide Therapy ◽

Neuroendocrine Tumours ◽

Somatostatin Receptor ◽

Peptide Receptor Radionuclide Therapy ◽

Clinical Results ◽

It Use ◽

Peptide Receptor ◽

Mibg Therapy

The incidence and prevalence of neuroendocrine tumours (NETs) are on the rise. Although NETs are a heterogeneous group of tumours, they have some similar properties, for example, that they can concentrate neuroamines and tend to have a high degree of somatostatin receptor (SSR) expression. These mechanisms can be exploited and this article discusses the important role of radionculide imaging and radionculide therapy in the management of NETs based on these mechanisms. This article reviews the current literature and discusses the role of radionuclide imaging in NETs both in terms of SSR imaging and neuroamine (metaiodobenzylguanidine [MIBG]) imaging. We discuss state-of- the-art 68Ga-radiopeptide imaging and indications for it use. We also discuss the role of 18F-FDG and other tracers in the management of NETs. The second half of the article focuses on radiotargeted treatment of NETs, discussing I-131 MIBG therapy and focussing on the emergence of peptide receptor radionuclide therapy. We discuss the clinical results, toxicities and patient selection for PRRT. Key words: DOTA octreotide, DOTATATE, Ga-68, Lu-177, metaiodobenzylguanidine, neuroendocrine tumours, peptide receptor radionuclide therapy, Y-90

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