Gastro-Enteric-Pancreatic Neuroendocrine Tumor Treatment: Actinium-225-DOTATATE and Combined Therapies

Swayamjeet Satapathy; Kunal Ramesh Chandekar; Chandrasekhar Bal

doi:10.1016/j.cpet.2022.11.004

Gastro-Enteric-Pancreatic Neuroendocrine Tumor Treatment: Actinium-225-DOTATATE and Combined Therapies

PET Clin. 2023 Apr;18(2):215-221. doi: 10.1016/j.cpet.2022.11.004.

Authors

Swayamjeet Satapathy¹, Kunal Ramesh Chandekar¹, Chandrasekhar Bal²

Affiliations

¹ Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
² Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. Electronic address: csbal@hotmail.com.

PMID: 36858746
DOI: 10.1016/j.cpet.2022.11.004

Abstract

The role of lutetium-177-DOTATATE in advanced well-differentiated gastro-entero-pancreatic neuroendocrine tumors is well established. However, there is a scope for improving treatment outcomes. Actinium-225-DOTATATE is a form of targeted alpha therapy (TAT) that results in more efficient tumor cell killing owing to the substantially higher linear energy transfer of alpha particles. Systemic TAT is also safe given that the shorter path length of the alpha particles spares the surrounding healthy tissue and results in relatively fewer adverse events. Combination therapies with radiosensitizing and other chemotherapeutic agents have also gained popularity, especially in the setting of higher grade and fluorodeoxyglucose-avid tumors.

Keywords: (225)Ac-DOTATATE; Capecitabine; GEP-NETs; Neuroendocrine tumors; PRRT; Peptide receptor radionuclide therapy; Targeted alpha therapy; Temozolomide.

Publication types

Review

MeSH terms

Actinium
Humans
Neuroendocrine Tumors*
Pancreatic Neoplasms*

Substances

Actinium-225
copper dotatate CU-64
Actinium