ECE2022 Debate Sessions PRRT or targeted molecular therapies as preferred line of treatment (2 abstracts)
Internal Medicine - Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands
Purpose: Bronchopulmonary (BP) and gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are slow-growing tumors, which frequently express somatostatin receptors on their cell membranes. These receptors are targets for therapy with 177Lutetium-labeled somatostatin analogues.
Experimental Design: Patients receive four treatments of 177Lu-DOTATATE at a dose of 7.4 GBq every 8 weeks
Results: An objective response rate of 39% was found for all BP & GEP NEN. Stable disease was reached in 43% of patients. Progression-free survival (PFS) and overall survival (OS) for all NET patients were 29 months (95% confidence interval (CI), 2633) and 63 months (95% CI, 5572). Long-term toxicity included acute leukemia (0.7%) and myelodysplastic syndrome (1.5%). No therapy-related long-term renal or hepatic failure occurred. The NETTER-1 study was the first randomized phase III study of 177Lu-DOTATATE and evaluated patients with midgut NENs who had progressed on standard doses of octreotide LAR. Patients were randomized to receive 177Lu-DOTATATE in combination with standard-dose octreotide or high-dose octreotide (60 mg/4 weeks) alone. Median OS was 48 months (95% CI, 37-55) in the 177Lu-DOTATATE group and 36 months (95% CI, 26-52) in the control group.
Conclusions: PRRT with 177Lu-DOTATATE is a favorable therapeutic option in patients with metastatic bronchial and gastroenteropancreatic NETs that express somatostatin receptors. PRRT with 177Lu-DOTATATE is safe with few side-effects and shows good response rates.
Speaker fees Ipsen, AAA-Novartis; research support AAA-Novartis.