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Review
. 2012 Feb;39 Suppl 1(Suppl 1):S103-12.
doi: 10.1007/s00259-011-2039-y.

Lutetium-labelled peptides for therapy of neuroendocrine tumours

B L R Kam  1 , J J M Teunissen, E P Krenning, W W de Herder, S Khan, E I van Vliet, D J Kwekkeboom
Affiliations
Review

Lutetium-labelled peptides for therapy of neuroendocrine tumours

B L R Kam et al. Eur J Nucl Med Mol Imaging. 2012 Feb.

Abstract

Treatment with radiolabelled somatostatin analogues is a promising new tool in the management of patients with inoperable or metastasized neuroendocrine tumours. Symptomatic improvement may occur with (177)Lu-labelled somatostatin analogues that have been used for peptide receptor radionuclide therapy (PRRT). The results obtained with (177)Lu-[DOTA(0),Tyr(3)]octreotate (DOTATATE) are very encouraging in terms of tumour regression. Dosimetry studies with (177)Lu-DOTATATE as well as the limited side effects with additional cycles of (177)Lu-DOTATATE suggest that more cycles of (177)Lu-DOTATATE can be safely given. Also, if kidney-protective agents are used, the side effects of this therapy are few and mild and less than those from the use of (90)Y-[DOTA(0),Tyr(3)]octreotide (DOTATOC). Besides objective tumour responses, the median progression-free survival is more than 40 months. The patients' self-assessed quality of life increases significantly after treatment with (177)Lu-DOTATATE. Lastly, compared to historical controls, there is a benefit in overall survival of several years from the time of diagnosis in patients treated with (177)Lu-DOTATATE. These findings compare favourably with the limited number of alternative therapeutic approaches. If more widespread use of PRRT can be guaranteed, such therapy may well become the therapy of first choice in patients with metastasized or inoperable neuroendocrine tumours.

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Figures

Fig. 1
Fig. 1
Typical example of better tumour uptake of 177Lu-DOTATATE (left) than that of 177Lu-DOTATOC (right) in the tumour of a patient with a gastroenteropancreatic NET which results in a longer mean residence time (mean residence time ratio 2.4 in favour of DOTATATE in this example). Adapted from reference [16]
Fig. 2
Fig. 2
Typical example of a partial response (PR) in a patient with a NET of the small bowel with liver metastases treated with 29.6 GBq 177Lu-DOTATATE. a CT scan showing multiple liver metastases before treatment. b CT scan 6 weeks after treatment with regression of liver metastases, consistent with a PR
See this image and copyright information in PMC

References

    1. Rinke A, Muller HH, Schade-Brittinger C, Klose KJ, Barth P, Wied M, et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol. 2009;27(28):4656–4663. doi: 10.1200/JCO.2009.22.8510. - DOI - PubMed
    1. Krenning EP, Bakker WH, Breeman WA, Koper JW, Kooij PP, Ausema L, et al. Localisation of endocrine-related tumours with radioiodinated analogue of somatostatin. Lancet. 1989;1(8632):242–244. doi: 10.1016/S0140-6736(89)91258-0. - DOI - PubMed
    1. Balon HR, Goldsmith SJ, Siegel BA, Silberstein EB, Krenning EP, Lang O, et al. Procedure guideline for somatostatin receptor scintigraphy with (111)In-pentetreotide. J Nucl Med. 2001;42(7):1134–1138. - PubMed
    1. Valkema R, De Jong M, Bakker WH, Breeman WA, Kooij PP, Lugtenburg PJ, et al. Phase I study of peptide receptor radionuclide therapy with [In-DTPA]octreotide: the Rotterdam experience. Semin Nucl Med. 2002;32(2):110–122. doi: 10.1053/snuc/2002.31025. - DOI - PubMed
    1. Anthony LB, Woltering EA, Espenan GD, Cronin MD, Maloney TJ, McCarthy KE. Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies. Semin Nucl Med. 2002;32(2):123–132. doi: 10.1053/snuc.2002.31769. - DOI - PubMed

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