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Review
. 2021 Mar 18;10(6):1267.
doi: 10.3390/jcm10061267.

Indications of Peptide Receptor Radionuclide Therapy (PRRT) in Gastroenteropancreatic and Pulmonary Neuroendocrine Tumors: An Updated Review

Baptiste Camus  1   2 , Anne-Ségolène Cottereau  2   3 , Lola-Jade Palmieri  1   2 , Solène Dermine  1   2 , Florence Tenenbaum  3 , Catherine Brezault  1   2 , Romain Coriat  1   2
Affiliations
Review

Indications of Peptide Receptor Radionuclide Therapy (PRRT) in Gastroenteropancreatic and Pulmonary Neuroendocrine Tumors: An Updated Review

Baptiste Camus et al. J Clin Med. .

Abstract

Radionuclide therapy for neuroendocrine tumors is a form of systemic radiotherapy that allows the administration of targeted radionuclides into tumor cells that express a large quantity of somatostatin receptors. The two most commonly used radio-peptides for radionuclide therapy in neuroendocrine tumors are 90Y-DOTATOC and 177Lu-DOTATATE. Radio-peptides have been used for several years in the treatment of advanced neuroendocrine tumors. Recently, the randomized Phase III study NETTER-1 compared177Lu-DOTATATE versus high-dose (double-dose) octreotide LAR in patients with metastatic midgut neuroendocrine tumors, and demonstrated its efficacy in this setting. Strong signals in favor of efficiency seem to exist for other tumors, in particular for pancreatic and pulmonary neuroendocrine tumors. This focus on radionuclide therapy in gastroenteropancreatic and pulmonary neuroendocrine tumors addresses the treatment modalities, the validated and potential indications, and the safety of the therapy.

Keywords: PRRT; gastroenteropancreatic tumor; neoplasm metastasis; neuroendocrine tumors; peptide receptor radionuclide therapy; pulmonary tumor.

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Conflict of interest statement

R.C. has acted as payed consultant or oral presenter for AAA, Ipsen, Novartis and Keocyt. A.-S.C. has acted as oral presenter for AAA. C.B. has acted as paid consultant of IPSEN. All other authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
A 65-year-old man with metastatic well-differentiated grade 2 rectal neuroendocrine tumor, progressive after chemotherapy, addressed for PRRT. 68Ga-DOTATOC PET/CT maximum intensity projection image (A) and axial fused PET/CT images (B,C) showed high multiple focal uptakes, corresponding to mediastinal, abdominal lymph nodes, liver and bone lesions ((C) arrow: example of bilateral cotyle posterior wall lesions) associated with a large rectal lesion ((B) arrow). Post 177Lu-DOTATATE therapy whole-body image (D) after the first administration showed focal tracer uptake in all lesions correlating with 68Ga-DOTATOC PET/CT images, as observed in fused SPECT/CT images (E,F).
Figure 2
Figure 2
A 54-year-old woman with metastatic well-differentiated ileal neuroendocrine tumor, progressive under somatostatin analogs, addressed for PRRT. Post 177Lu-DOTATATE therapy whole-body image after the first administration (A) showed multiple foci of uptake including a large left subclavicular node (dotted arrow), liver lesions and large retroperitoneal lymph nodes (arrow) as illustrated in axial SPECT/CT fused (B) and CT (C) images. After the fourth administration, the treatment scintigraphy already detected partial response, with a decreased uptake in several lymph nodes (D), particularly in subclavicular (dotted arrow) and para-aortic sites (arrow), also associated with decreased in size, as demonstrated in axial SPECT/CT fusion (E) and CT (F) images.
See this image and copyright information in PMC

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