177Lu-DOTATATE treatment in neuroendocrine tumours. A preliminary study

Rev Esp Med Nucl Imagen Mol. 2017 Mar-Apr;36(2):91-98. doi: 10.1016/j.remn.2016.10.003. Epub 2016 Nov 23.
[Article in English, Spanish]

Abstract

Therapy with radiolabelled somatostatin analogue peptides is a promising new therapy to treat neuroendocrine tumours. The aim of this preliminary study is to present our experience with 177Lu-DOTATATE therapy, and evaluate tolerability and short-term efficacy in patients with tumours expressing somatostatin receptors. A total of 7 patients with metastatic neuroendocrine tumours were treated, each with 4 doses of 177Lu-DOTATATE. The treatment response was evaluated in the form of biochemical response (tumour markers), imaging methods (somatostatin receptor scintigraphy, computed tomography, and magnetic resonance), and functional and quality of life responses using the Karnofsky performance status scale. Treatment toxicity was also evaluated. The results obtained were as follows: Biochemical response: 60% of patients showed tumour marker levels returning to normal, while they decreased significantly in the remaining 40%. Imaging response: 85.7% had a partial response, while 14.3% showed stable disease. All (100%) patients showed a significant improvement in quality of life, with increased Karnofsky scale scores. No patient had acute or chronic toxicity, and subacute transient haematological toxicity was observed in 42.8% of patients. Despite being a preliminary study, it was found that treatment with 177Lu-DOTATATE is a safe treatment with few side effects, and an objective response was achieved in most patients.

Keywords: (177)Lu-DOTATATE; Neuroendocrine tumours; Radionuclide therapy; Terapia con radionúclidos; Tumores neuroendocrinos.

MeSH terms

  • Adult
  • Aged
  • Biomarkers, Tumor / analysis
  • Female
  • Humans
  • Karnofsky Performance Status
  • Lutetium / adverse effects
  • Lutetium / pharmacokinetics
  • Lutetium / therapeutic use*
  • Male
  • Middle Aged
  • Neoplasm Proteins / analysis
  • Neuroendocrine Tumors / radiotherapy*
  • Neuroendocrine Tumors / secondary
  • Octreotide / adverse effects
  • Octreotide / analogs & derivatives*
  • Octreotide / pharmacokinetics
  • Octreotide / therapeutic use
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / pharmacokinetics
  • Organometallic Compounds / therapeutic use*
  • Quality of Life
  • Radioisotopes / adverse effects
  • Radioisotopes / pharmacokinetics
  • Radioisotopes / therapeutic use*
  • Radionuclide Imaging / methods
  • Radiopharmaceuticals / adverse effects
  • Radiopharmaceuticals / pharmacokinetics
  • Radiopharmaceuticals / therapeutic use*
  • Receptors, Somatostatin / analysis
  • Tissue Distribution
  • Treatment Outcome
  • Whole Body Imaging / methods
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Neoplasm Proteins
  • Organometallic Compounds
  • Radioisotopes
  • Radiopharmaceuticals
  • Receptors, Somatostatin
  • Lutetium
  • lutetium Lu 177 dotatate
  • Lutetium-177
  • Octreotide