ICEECE2012 Poster Presentations Endocrine tumours and neoplasia (112 abstracts)
Is combined radionuclide therapy with 90y-Dotatate and 177lu-Dotatate an effective treatment option for patients with metastasised neuroendocrine tumours? An ongoing study
E. Seregni , M. Vincenzo , F. De Braud , R. Buzzoni , M. Marco , A. Coliva , C. Pascali , A. Mallia & E. Bombardieri
Fondazione IRCCS "Istituto Nazionale dei Tumori", Milan, Italy.
Introduction: Neuroendocrine tumors (NETs) over-express somatostatin receptors (SRs) and the efficacy of peptide receptor radionuclide therapy (PRRT) with somatostatin analogues labeled with high activities of β-emitting radioisotopes has been reported.
Aim: Ongoing study to evaluate efficacy and toxicity of combination treatment with 4 cycles of radiolabeled DOTATATE, alternating 177Lu and 90Yin patients with metastasised NETs expressing SRs refractory to conventional therapies.
Method: Since 2008 forty-four patients with disseminated NETs were included in the study prospectively to be treated with 4 cycles of PRRT, alternating 177Lu-DOTATATE (5.55 GBq) and 90Y-DOTATATE (2.6 GBq).Dosimetric evaluation on each patient was performed following administration of 177Lu-DOTATATE. Hematological and renal toxicities are graded according to WHO toxicity grading scales and treatment efficacy evaluated using RECIST criteria. Quality of life is assessed following each treatment cycle.
Results: So far twenty-six patients have completed all 4 cycles together with a 6 month treatment evaluation (SD=38.5%, PR=38.5%, CR=8% and PD=15%). A symptomatic improvement was reported by 90% of patients with pre-treatment carcinoid syndrome. The remaining eighteen patients are currently undergoing treatment. Side effects and blood toxicities were rare, mild and transient. To date no renal or hepatic toxicities have been observed. Average tumor absorbed doses were 13–63 Gy for 177-Lu and 20–93 Gy for 90Y.
Conclusions: Combined PRRT therapy represents an innovative treatment strategy for patients with metastatic NETs with the aim of improving therapy efficacy.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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