Peptide receptor radionuclide therapy for neuroendocrine tumors in Germany: Initial results of a multiinstitutional cancer registry.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14513-e14513
Author(s):  
Dieter Hörsch ◽  

e14513 Background: Peptide receptor radionuclide therapy is an effective treatment option for patients with well differentiated somatostatin receptor expressing neuroendocrine tumors. However, published data results mainly from retrospective monocentric studies. Methods: We initiated a multi-institutional, prospective and board reviewed registry for patients treated with Peptide receptor radionuclide therapy in Germany in 2009. Results: In five centers, 297 patients were registered. Primary tumors were mainly derived from pancreas (117/297), small intestine (80/297) whereas 56 were of unknown primary. Most tumors were well differentiated with a median Ki67 proliferation rate of 5% (range 0.9 to 70). Peptide receptor radionuclide therapy was performed using mainly Yttrium-90 and/or Lutetium-177 as radionuclides in 1-8 cycles. Mean overall survival was estimated at 213 months with a follow up between 1 and 230 months after initial diagnosis and 87 months with a follow up between 1 and 92 months after start of Peptide receptor radionuclide therapy. Median overall survival was not yet reached. Subgroup analysis demonstrated that best results were obtained in neuroendocrine tumors with a proliferation rate below 20%. Conclusions: Our results indicate that Peptide receptor radionuclide therapy is an effective treatment well and moderately differentiated neuroendocrine tumors irrespective of previous therapies and should be regarded a one of the primary treatment options for patients with neuroendocrine tumors.

Pharmaceutics ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1463
Author(s):  
Licia Uccelli ◽  
Alessandra Boschi ◽  
Corrado Cittanti ◽  
Petra Martini ◽  
Stefano Panareo ◽  
...  

The PRRT (Peptide Receptor Radionuclide Therapy) is a promising modality treatment for patients with inoperable or metastatic neuroendocrine tumors (NETs). Progression-free survival (PFS) and overall survival (OS) of these patients are favorably comparable with standard therapies. The protagonist in this type of therapy is a somatostatin-modified peptide fragment ([Tyr3] octreotide), equipped with a specific chelating system (DOTA) capable of creating a stable bond with β-emitting radionuclides, such as yttrium-90 and lutetium-177. In this review, covering twenty five years of literature, we describe the characteristics and performances of the two most used therapeutic radiopharmaceuticals for the NETs radio-treatment: [90Y]Y-DOTATOC and [177Lu]Lu-DOTATOC taking this opportunity to retrace the most significant results that have determined their success, promoting them from preclinical studies to application in humans.


Pancreas ◽  
2017 ◽  
Vol 46 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Nancy Sharma ◽  
Boris G. Naraev ◽  
Eric G. Engelman ◽  
M. Bridget Zimmerman ◽  
David L. Bushnell ◽  
...  

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4113-4113
Author(s):  
Andreja Frilling ◽  
Ashley Clift ◽  
Adil Al-Nahhas ◽  
Richard P. Baum ◽  
Daniel Kaemmerer

4113 Background: Neuroendocrine neoplasia (NEN) of the pancreas (PanNEN) or small bowel (SBNEN) frequently present with metastases at initial diagnosis, undermining the efficacy of surgical treatment. Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues, 90Y-DOTATOC and 177Lu-DOTATATE, has been shown to achieve prolonged progression-free survival (PFS) and overall survival (OS) in a substantial number of non-surgical patients with advanced NEN. Our aim was to prospectively determine the efficacy of a combination of radical loco-regional surgery and 177Lu PRRT in patients with metastasised NEN. Methods: A set of inclusion criteria was defined (e.g. PanNEN or SBNEN, G1/G2 NEN, initial tumour diagnosis, treatment naïve patient, stage IV NEN, positivity on 68Ga DOTATATE or DOTATOC PET/CT, eligibility for surgery and PRRT). Patients underwent PRRT within 3 months following surgery. Follow-up included biochemistry and imaging. Outcome measures included 1-, 3-, and 5-year OS and PFS from initial diagnosis. Results: Forty-one patients met eligibility criteria and were included. There were 26 males (63.4%) and median age at surgery was 58.8 years (range 32.1-78.3). All patients with SBNEN underwent right hemicolectomy, terminal ileal resection and mesenteric lympadenectomy. In PanNEN patients either Whipple procedure or distal pancreatectomy and peripancreatic lymphadenectomy were performed. The median number of PRRT cycles was 4 (range 2-6). Post-treatment mortality was 0%. Surgical morbidity was 12% (all grade 1 according Clavien-Dindo) and transient grade 1 toxicity occurred post PRRT in 40%. There was no grade 3 toxicity. Median follow-up was 5.48 years (range 0.53 – 11.98). Median PFS and OS were 3.33 years and 9.07 years, respectively. Progression-free survival (with 95% CI) was at 1-, 3-, and 5-years 80% (68.7-92.6), 60.9% (45.9-75.9) and 43.3% (27.4-59.3), respectively. Overall survival (with 95% CI) at 1-, 3-, and 5-years was 97.6% (93-100), 97.6% (93-100), and 95% (87-100), respectively. Conclusions: Radical loco-regional surgery for primary tumours combined with PRRT provides a novel, highly efficacious approach in metastasised NEN.


2019 ◽  
Vol 12 (2) ◽  
pp. 126-134 ◽  
Author(s):  
Shahad Alsadik ◽  
Siraj Yusuf ◽  
Adil AL-Nahhas

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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