'Pseudo-resistance' in macroprolactinomas treated with dopamine agonists; recognising delayed radiological response and a role for 11C-methionine PET-CT in guiding management

Abstract Background Advanced salivary gland cancers become difficult to treat when they are technically irresectable and radiotherapy limits are exceeded. There is also an unmet need to improve palliative systemic therapy. Salivary glands depict the Prostate-Specific Membrane Antigen (PSMA) on 68Ga-PSMA-PET/CT, a transmembrane protein that is targeted for diagnosis and treatment of advanced prostate cancer. Some salivary gland carcinomas also express PSMA. Methods This study aimed to retrospectively evaluate the effectiveness of 177Lu-PSMA-617 therapy for recurrent or metastatic salivary gland cancers, as a last resort treatment. Patients with serious tumour-related discomfort for whom no regular option was available were selected and critically re-assessed by the tumour board. Radionuclide therapy eligibility was confirmed when tumour targeting was greater than liver SUVmax on 68Ga-PSMA-PET/CT. The protocol aimed at four cycles of 6.0–7.4 GBq 177Lu-PSMA-617 every 6–8 weeks. Clinical response was evaluated by questionnaires and radiological response by 68Ga-PSMA-PET/CT. Results Six patients were treated with 177Lu-PSMA: four adenoid cystic carcinomas, one adenocarcinoma NOS and one acinic cell carcinoma. In two patients, radiological response was observed, showing either stable disease or a partial response, and four patients reported immediate relief of tumour-related symptoms. Most reported side effects were grade 1–2 fatigue, nausea, bone pain and xerostomia. Four patients prematurely discontinued therapy: three due to disease progression and one due to demotivating (grade 1) side-effects. Conclusions Palliative 177Lu-PSMA therapy for salivary gland cancer may lead to rapid relief of tumour-associated discomfort and may even induce disease stabilization. It is safe, relatively well tolerated and can be considered when regular treatment options fail.

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Predictive Role of MRI and 18F FDG PET Response to Concurrent Chemoradiation in T2b Cervical Cancer on Clinical Outcome: A Retrospective Single Center Study

Cancers ◽

10.3390/cancers12030659 ◽

2020 ◽

Vol 12 (3) ◽

pp. 659 ◽

Cited By ~ 2

Author(s):

Anna Myriam Perrone ◽

Giulia Dondi ◽

Manuela Coe ◽

Martina Ferioli ◽

Silvi Telo ◽

...

Keyword(s):

Cervical Cancer ◽

Tumor Response ◽

Locally Advanced ◽

False Negative ◽

Response To Therapy ◽

Imaging Tool ◽

Pet Ct ◽

Before And After ◽

Radiological Response

Tumor response in locally advanced cervical cancer (LACC) is generally evaluated with MRI and PET, but this strategy is not supported by the literature. Therefore, we compared the diagnostic performance of these two techniques in the response evaluation to concurrent chemoradiotherapy (CCRT) in LACC. Patients with cervical cancer (CC) stage T2b treated with CCRT and submitted to MRI and PET/CT before and after treatment were enrolled in the study. All clinical, pathological, therapeutic, radiologic and follow-up data were collected and examined. The radiological response was analyzed and compared to the follow-up data. Data of 40 patients with LACC were analyzed. Agreement between MRI and PET/CT in the evaluation response to therapy was observed in 31/40 (77.5%) of cases. The agreement between MRI, PET/CT and follow-up data showed a Cohen kappa coefficient of 0.59 (95% CI = 0.267–0.913) and of 0.84 (95% CI = 0.636–1.00), respectively. Considering the evaluation of primary tumor response, PET/CT was correct in 97.5% of cases, and MRI in 92.5% of cases; no false negative cases were observed. These results suggest the use of PET/CT as a unique diagnostic imaging tool after CCRT, to correctly assess residual and progression disease.

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1596: Lymph Node Staging in Prostate Cancer by the use of 11C-CHOLIN-PET/CT Scan Imaging

The Journal of Urology ◽

10.1016/s0022-5347(18)35718-5 ◽

2005 ◽

Vol 173 (4S) ◽

pp. 432-432

Author(s):

Georg C. Bartsch ◽

Norbert Blumstein ◽

Ludwig J. Rinnab ◽

Richard E. Hautmann ◽

Peter M. Messer ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Ct Scan ◽

Lymph Node Staging ◽

Pet Ct ◽

Pet Ct Scan

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Caution Required in Use of Dopamine Agonists, Given Known Cardiac Risks

Clinical Neurology News ◽

10.1016/s1553-3212(07)70338-2 ◽

2007 ◽

Vol 3 (11) ◽

pp. 16

Author(s):

KATE JOHNSON

Keyword(s):

Dopamine Agonists

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Diese unglaubliche Müdigkeit und immer wieder abends Fieber und Kopfschmerzen

Praxis ◽

10.1024/1661-8157/a002777 ◽

2017 ◽

Vol 106 (19) ◽

pp. 1061-1064

Author(s):

Katharina Brodsky ◽

Dominique Oberlin ◽

Reto Nüesch

Keyword(s):

Sich Eine ◽

Pet Ct

Zusammenfassung. Wir berichten über einen 58-jährigen Patienten mit seit Monaten bestehender B-Symptomatik, rezidivierenden Fieberschüben begleitet von Kopfschmerzen und erhöhten Entzündungsparametern. In der Erstlinienabklärung ergaben sich keine eindeutigen Hinweise auf eine infektiologische oder rheumatologische Ursache, auffällig war lediglich eine mediastinale und hiläre Lymphadenopathie. Zum Ausschluss eines Malignoms wurde eine PET-CT durchgeführt, in der sich eine FDG-Aufnahme im Bereich der grossen Gefässe zeigte, passend zu einer Riesenzellarteritis. Bei eindeutigem Befund konnte auf einen Temporalarterienbiopsie verzichtet und eine Therapie mit Glukokortikoiden begonnen werden.

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