ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
Our experience with lu-dotatate in patients with neuroendocrine tumors in a tertiary hospital
Diego Munoz , Juan Carlos Percovich Hualpa , Bettina Weber , José Atencia Goñi , Laura González Fernández , María Miguélez González , Noemí Brox Torrecilla , Roberto José Añez Ramos , Alejandra Maricel Rivas Montenegro , Aurelio López Guerra , Yoko Lucía Olmedilla Isishi , María Ángeles Vélez Romero , Javier Ágreda García , María Picallo Pérez , Susana Monereo Megías & Rogelio García Centeno
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Introduction: Lutetium-177-DOTATATE (Lu177) is approved in patients with well-differentiated (G1 and G2) neuroendocrine tumors (NETs) positive to somatostatin receptors, progressive and unresectable or metastatic. Lu177 has been shown to increase progression-free survival and the quality of life of these patients.
Material and Methods: Retrospective descriptive study of a series of 15 cases with NETs treated with Lu177. Demographic data, tumor characteristics, previous and concomitant treatments, response to Lu177 treatment and possible adverse reactions have been collected.
Results: We describe 15 patients, 9 men and 6 women with 62 ± 11 years old of average age. The location of the primary tumor was ileum in 7 patients, pancreas in another 7 and lung in 1. Regarding the degree of differentiation, 5 were G1 (33%), 8 G2 (53%) and 2 G3 (13%). All of them presented liver metastases, 7 lymphatic, 2 bone, 4 peritoneal implants and 1 ovarian metastases. 11 of them were functional, the remaining 4 were not. As a concomitant treatment, everyone was receiving somatostatin analogues (13 lanreotide and 2 octreotide). As previous treatments, 6 had received everolimus, 4 chemotherapy with cisplatin + etoposide and 5 intrahepatic treatment (embolization with yttrium spheres). In all of them uptake was visible in scintigraphy with analogues prior to treatment with lutetium. 11 patients completed the 4 doses of 200 mC1, 1 received 3 cycles, another 2 cycles and 2 patients 1 cycle. The follow-up time was 6 to 42 months. The radiological response of the lesions (according to RECIST 1.1 criteria) was partial response in 3 patients (27%), stabilization in 2 (18%) and tumor progression in 6 (54%) of them (2 exitus for this reason). In the 5 patients with partial response or tumor stabilization there was also a metabolic response mesured by Octreoscan and a biochemical response with decreased levels of Chromogranin A. 4 are waiting to complete the cycles. Adverse reactions have all been self-limited, the most frequent were gastrointestinal (nausea 26% and vomiting 20%), mild thrombocytopenia(26%), mild anemia (6.6%) and mild neutropenia (6.6%). No anaphylaxis or nephrotoxicity reactions have been observed.
Conclusions: In our experience, treatment with Lu177 in patients with metastasic NETs has been able to control the disease in 45% of the patients that completed the 4 cycles with mild gastrointestinal and hematological adverse effects. Lu177 treatment is an excellent therapeutic option, as long as it is decided within the consensus of a multidisciplinary team.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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