. 2022 Feb:162:221-236.

doi: 10.1016/j.ejca.2021.09.046. Epub 2021 Dec 31.

Clinical outcomes, Kadish-INSICA staging and therapeutic targeting of somatostatin receptor 2 in olfactory neuroblastoma

Matt Lechner¹, Yoko Takahashi², Mario Turri-Zanoni³, Jacklyn Liu⁴, Nicholas Counsell⁵, Mario Hermsen⁶, Raman Preet Kaur⁷, Tianna Zhao⁸, Murugappan Ramanathan Jr⁷, Volker H Schartinger⁹, Oscar Emanuel⁴, Sam Helman¹⁰, Jordan Varghese¹⁰, Jozsef Dudas⁹, Herbert Riechelmann⁹, Susanne Sprung¹¹, Johannes Haybaeck¹², David Howard¹³, Nils Wolfgang Engel¹⁴, Sarah Stewart¹⁵, Laura Brooks¹⁵, Jessica C Pickles¹⁶, Thomas S Jacques¹⁶, Tim R Fenton¹⁷, Luke Williams¹⁸, Francis M Vaz¹⁹, Paul O'Flynn¹⁹, Paul Stimpson¹⁹, Simon Wang²⁰, S Alam Hannan¹⁹, Samit Unadkat¹⁹, Jonathan Hughes¹⁵, Raghav Dwivedi¹⁵, Cillian T Forde¹⁹, Premjit Randhawa¹⁹, Simon Gane¹⁹, Jonathan Joseph¹⁹, Peter J Andrews¹⁹, Gary Royle⁴, Alessandro Franchi²¹, Roberta Maragliano²², Simonetta Battocchio²³, Helen Bewicke-Copley⁴, Christodoulos Pipinikas⁴, Amy Webster⁴, Chrissie Thirlwell²⁴, Debbie Ho²⁵, Andrew Teschendorff²⁶, Tianyu Zhu²⁶, Christopher D Steele⁸, Nischalan Pillay⁴, Bart Vanhaesebroeck⁴, Ahmed Mohyeldin²⁷, Juan Fernandez-Miranda²⁷, Ki Wan Park²⁸, Quynh-Thu Le²⁹, Robert B West²⁹, Rami Saade², R Peter Manes³⁰, Sacit Bulent Omay³⁰, Eugenia M Vining³⁰, Benjamin L Judson³⁰, Wendell G Yarbrough³¹, Maddalena Sansovini³², Nicolini Silvia³², Ilaria Grassi³², Alberto Bongiovanni³³, David Capper³⁴, Ulrich Schüller³⁵, Selvam Thavaraj³⁶, Ann Sandison³⁷, Pavol Surda³⁸, Claire Hopkins³⁸, Marco Ferrari³⁹, Davide Mattavelli⁴⁰, Vittorio Rampinelli⁴⁰, Fabio Facchetti²³, Piero Nicolai³⁹, Paolo Bossi⁴¹, Oswaldo A Henriquez¹⁰, Kelly Magliocca⁴², C Arturo Solares¹⁰, Sarah K Wise¹⁰, Jose L Llorente⁴³, Zara M Patel²⁸, Jayakar V Nayak²⁸, Peter H Hwang²⁸, Peter D Lacy⁴⁴, Robbie Woods⁴⁴, James P O'Neill⁴⁵, Amrita Jay⁴⁶, Dawn Carnell¹⁵, Martin D Forster⁴⁷, Masaru Ishii⁷, Nyall R London Jr⁴⁸, Diana M Bell⁴⁹, Gary L Gallia⁵⁰, Paolo Castelnuovo³, Stefano Severi³², Valerie J Lund⁵¹, Ehab Y Hanna⁵²

Affiliations

¹ UCL Cancer Institute, University College London, London, UK; Academic Head and Neck Centre, UCL Division of Surgery and Interventional Science, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, United Kingdom; Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA. Electronic address: m.lechner@ucl.ac.uk.
² Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA.
³ Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy.
⁴ UCL Cancer Institute, University College London, London, UK.
⁵ Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK.
⁶ Department of Head and Neck Oncology, Instituto de Investigacio´n Sanitaria Del Principado de Asturias (ISPA), Instituto Universitario de Oncologı´a Del Principado de Asturias (IUOPA), Centro de Investigacio´n Biome´dica en Red (CIBER-ONC), Oviedo, Spain.
⁷ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA.
⁸ Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA.
⁹ Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA.
¹¹ Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria.
¹² Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria; Diagnostic & Research Center for Molecular BioMedicine, Institute of Pathology, Medical University Graz, Graz, Austria.
¹³ Head and Neck Cancer Unit, Imperial College Healthcare NHS Trust, London, UK.
¹⁴ Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁵ Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
¹⁶ Department of Developmental Biology and Cancer & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
¹⁷ School of Biosciences, University of Kent, Canterbury, UK; School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁸ UCL Division of Surgery and Interventional Science, University College London, London, UK.
¹⁹ Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
²⁰ Institute of Nuclear Medicine, University College London, London, UK.
²¹ Department of Translational Research, University of Pisa, Pisa, Italy.
²² Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy.
²³ Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy.
²⁴ UCL Cancer Institute, University College London, London, UK; College of Medicine and Health and Institute of Biomedical and Clinical Science, University of Exeter, Exeter, UK.
²⁵ Stem Cell Institute, University of Cambridge, Cambridge, UK.
²⁶ CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Shanghai, China.
²⁷ Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, USA.
²⁸ Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA.
²⁹ Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, USA.
³⁰ Department of Neurosurgery, Yale School of Medicine, New Haven, USA.
³¹ Department of Otolaryngology/Head and Neck Surgery, UNC School of Medicine, Chapel Hill, NC, USA.
³² Therapeutic Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
³³ Osteoncology and Rare Tumors Center (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
³⁴ Department of Neuropathology, Charite - Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany.
³⁵ Department of Pediatric Hematology and Oncology, Institute of Neuropathology, And Research Institute Children's Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³⁶ Centre for Clinical, Oral & Translational Science, King's College London, Department of Head and Neck Pathology, Guy's Hospital, London, UK.
³⁷ Department of Head and Neck Pathology, Guy's Hospital, London, UK.
³⁸ Guy's Hospital, King's College, London, UK.
³⁹ Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Italy.
⁴⁰ Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
⁴¹ Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
⁴² Department of Pathology, Emory University School of Medicine, Atlanta, USA.
⁴³ Dept Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
⁴⁴ Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland.
⁴⁵ Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland; The Royal College of Surgeons in Ireland, Dublin, Ireland.
⁴⁶ Department of Histopathology, University College London Hospitals NHS Trust, London, UK.
⁴⁷ UCL Cancer Institute, University College London, London, UK; Academic Head and Neck Centre, UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴⁸ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA; Sinonasal and Skull Base Tumor Program, Head and Neck Surgery Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
⁴⁹ Department of Pathology, The University of Texas MD Anderson Cancer Center Houston, USA; Division of Anatomic Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
⁵⁰ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA.
⁵¹ Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK. Electronic address: v.lund@ucl.ac.uk.
⁵² Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: EYHanna@mdanderson.org.

PMID: 34980502
PMCID: PMC9554673
DOI: 10.1016/j.ejca.2021.09.046

Clinical outcomes, Kadish-INSICA staging and therapeutic targeting of somatostatin receptor 2 in olfactory neuroblastoma

Matt Lechner et al. Eur J Cancer. 2022 Feb.

. 2022 Feb:162:221-236.

doi: 10.1016/j.ejca.2021.09.046. Epub 2021 Dec 31.

Authors

Affiliations

¹ UCL Cancer Institute, University College London, London, UK; Academic Head and Neck Centre, UCL Division of Surgery and Interventional Science, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, United Kingdom; Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA. Electronic address: m.lechner@ucl.ac.uk.
² Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA.
³ Unit of Otorhinolaryngology and Head & Neck Surgery, Department of Biotechnology and Life Sciences, ASST Sette Laghi, University of Insubria, Varese, Italy.
⁴ UCL Cancer Institute, University College London, London, UK.
⁵ Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK.
⁶ Department of Head and Neck Oncology, Instituto de Investigacio´n Sanitaria Del Principado de Asturias (ISPA), Instituto Universitario de Oncologı´a Del Principado de Asturias (IUOPA), Centro de Investigacio´n Biome´dica en Red (CIBER-ONC), Oviedo, Spain.
⁷ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA.
⁸ Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA.
⁹ Department of Otorhinolaryngology, Medical University of Innsbruck, Innsbruck, Austria.
¹⁰ Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, USA.
¹¹ Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria.
¹² Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria; Diagnostic & Research Center for Molecular BioMedicine, Institute of Pathology, Medical University Graz, Graz, Austria.
¹³ Head and Neck Cancer Unit, Imperial College Healthcare NHS Trust, London, UK.
¹⁴ Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
¹⁵ Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
¹⁶ Department of Developmental Biology and Cancer & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK; Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
¹⁷ School of Biosciences, University of Kent, Canterbury, UK; School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
¹⁸ UCL Division of Surgery and Interventional Science, University College London, London, UK.
¹⁹ Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK.
²⁰ Institute of Nuclear Medicine, University College London, London, UK.
²¹ Department of Translational Research, University of Pisa, Pisa, Italy.
²² Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy.
²³ Pathology Unit, Department of Molecular and Translational Medicine, University of Brescia, ASST Spedali Civili, Brescia, Italy.
²⁴ UCL Cancer Institute, University College London, London, UK; College of Medicine and Health and Institute of Biomedical and Clinical Science, University of Exeter, Exeter, UK.
²⁵ Stem Cell Institute, University of Cambridge, Cambridge, UK.
²⁶ CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Shanghai, China.
²⁷ Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, USA.
²⁸ Rhinology & Endoscopic Skull Base Surgery, Department of Otolaryngology-H&N Surgery, Stanford University School of Medicine, Palo Alto, USA.
²⁹ Department of Radiation Oncology, Stanford University School of Medicine, Palo Alto, USA.
³⁰ Department of Neurosurgery, Yale School of Medicine, New Haven, USA.
³¹ Department of Otolaryngology/Head and Neck Surgery, UNC School of Medicine, Chapel Hill, NC, USA.
³² Therapeutic Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
³³ Osteoncology and Rare Tumors Center (CDO-TR), IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
³⁴ Department of Neuropathology, Charite - Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany; German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany.
³⁵ Department of Pediatric Hematology and Oncology, Institute of Neuropathology, And Research Institute Children's Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
³⁶ Centre for Clinical, Oral & Translational Science, King's College London, Department of Head and Neck Pathology, Guy's Hospital, London, UK.
³⁷ Department of Head and Neck Pathology, Guy's Hospital, London, UK.
³⁸ Guy's Hospital, King's College, London, UK.
³⁹ Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padova, Italy.
⁴⁰ Unit of Otorhinolaryngology - Head and Neck Surgery, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
⁴¹ Medical Oncology, Department of Medical and Surgical Specialities, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
⁴² Department of Pathology, Emory University School of Medicine, Atlanta, USA.
⁴³ Dept Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
⁴⁴ Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland.
⁴⁵ Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland; The Royal College of Surgeons in Ireland, Dublin, Ireland.
⁴⁶ Department of Histopathology, University College London Hospitals NHS Trust, London, UK.
⁴⁷ UCL Cancer Institute, University College London, London, UK; Academic Head and Neck Centre, UCL Division of Surgery and Interventional Science, University College London, London, UK; Department of Oncology, Haematology and Bone Marrow Transplantation with Section Pneumology, Hubertus Wald Tumorzentrum, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁴⁸ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA; Sinonasal and Skull Base Tumor Program, Head and Neck Surgery Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
⁴⁹ Department of Pathology, The University of Texas MD Anderson Cancer Center Houston, USA; Division of Anatomic Pathology, City of Hope Comprehensive Cancer Center, Duarte, CA, United States.
⁵⁰ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, USA.
⁵¹ Royal National Ear, Nose and Throat Hospital and Head and Neck Centre, University College London Hospitals NHS Trust, London, UK. Electronic address: v.lund@ucl.ac.uk.
⁵² Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA. Electronic address: EYHanna@mdanderson.org.

PMID: 34980502
PMCID: PMC9554673
DOI: 10.1016/j.ejca.2021.09.046

Abstract

Introduction: Olfactory neuroblastoma (ONB) is a rare cancer of the sinonasal region. We provide a comprehensive analysis of this malignancy with molecular and clinical trial data on a subset of our cohort to report on the potential efficacy of somatostatin receptor 2 (SSTR2)-targeting imaging and therapy.

Methods: We conducted a retrospective analysis of 404 primary, locally recurrent, and metastatic olfactory neuroblastoma (ONB) patients from 12 institutions in the United States of America, United Kingdom and Europe. Clinicopathological characteristics and treatment approach were evaluated. SSTR2 expression, SSTR2-targeted imaging and the efficacy of peptide receptor radionuclide therapy [PRRT](¹⁷⁷Lu-DOTATATE) were reported in a subset of our cohort (LUTHREE trial; NCT03454763).

Results: Dural infiltration at presentation was a significant predictor of overall survival (OS) and disease-free survival (DFS) in primary cases (n = 278). Kadish-Morita staging and Dulguerov T-stage both had limitations regarding their prognostic value. Multivariable survival analysis demonstrated improved outcomes with lower stage and receipt of adjuvant radiotherapy. Prophylactic neck irradiation significantly reduces the rate of nodal recurrence. 82.4% of the cohort were positive for SSTR2; treatment of three metastatic cases with SSTR2-targeted peptide-radionuclide receptor therapy (PRRT) in the LUTHREE trial was well-tolerated and resulted in stable disease (SD).

Conclusions: This study presents pertinent clinical data from the largest dataset, to date, on ONB. We identify key prognostic markers and integrate these into an updated staging system, highlight the importance of adjuvant radiotherapy across all disease stages, the utility of prophylactic neck irradiation and the potential efficacy of targeting SSTR2 to manage disease.

Keywords: Adjuvant; Diagnostic imaging; Esthesioneuroblastoma; Human; Olfactory; Prognosis; Radiotherapy; Receptors; SSTR2 protein; Somatostatin.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement NL receives research funding from Merck Inc., not related to this manuscript, and was a consultant for CoolTech Inc. and holds stock in Navigen Pharmaceuticals, both of which are unrelated to this manuscript. SW is on the advisory board of ALK, Genentech, OptiNose, SinopSys and a Consultant to NeurENT, Stryker, all of which are unrelated to this manuscript. All other authors declare no potential relevant conflicts of interest.

Figures

**Figure 1:. Clinical characteristics of olfactory neuroblastoma.**
A) Anatomical localization and representative images of histology (H&E staining), expression of common markers (S100, chromogranin A, synaptophysin) and SSTR2, which were assessed by immunohistochemistry; B) Heatmap representation of clinical annotations; C) Bar graph representation of common symptoms at presentation; D) Kaplan-Meier overall survival of primary cases.

**Figure 2.. Survival outcomes of primary cases by clinicopathological characteristics and treatment approach.**
Univariable and multivariable Cox regression survival analysis of clinicopathological characteristics and treatment approach.

**Figure 3.. Survival outcomes of primary cases by clinicopathological characteristic.**
A) Kaplan-Meier survival of Hyams Grade. B) Kaplan-Meier survival curve of Kadish-Morita stage. C) Kaplan-Meier survival curve of Dulguerov T-stage. D) Kaplan-Meier survival curve of a modification of the Kadish-Morita staging, which stratifies the Kadish C group into those who present with or without dural infiltration.

**Figure 4.. Survival outcomes of primary cases by clinicopathological characteristics and treatment approach.**
A)-D) Kaplan-Meier survival analyses demonstrating survival differences between patients who receive adjuvant radiotherapy and those who do not; further analyses of early-stage patients also demonstrated. E) Number of recurrences (occurring 10 years post-initial diagnosis of the primary or earlier) at the cervical lymph nodes, considering receipt of adjuvant radiotherapy to the primary tumor only, compared to additional prophylactic neck irradiation. Kaplan-Meier event-free (where event is cervical lymph node recurrence) survival analysis demonstrating the difference in the incidence of cervical lymph node recurrence between patients who receive adjuvant radiotherapy to the primary tumor only, compared to the ones who receive additional prophylactic neck irradiation.

**Figure 5:. Confirmation of SSTR2 expression in local recurrences and metastases and clinical trial on Somatostatin receptor (SSTR) 2-positive olfactory neuroblastoma.**
A) Representative images of SSTR2 expression, with corresponding H&E, in local recurrence and lymph node metastasis, determined by IHC. B)-D) Immunohistochemical characterization of tumor biopsies (SSTR2 and Chromogranin correlation of SSTR2 IHC with *in vivo* uptake of ⁶⁸Ga-DOTATATE in PET MRI imaging of 3 patients who were enrolled in the LUTHREE trial (NCT03454763) and underwent SSTR2-targeted peptide-radionuclide receptor therapy (PRRT). Pre-treatment ⁶⁸Ga-DOTATATE PET MRI with corresponding MRI and subsequent MRI 1-year post-treatment.

**Figure 6:. Kadish-INSICA staging system.**
Definitions and proposed management guidelines.

See this image and copyright information in PMC

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Clinical outcomes, Kadish-INSICA staging and therapeutic targeting of somatostatin receptor 2 in olfactory neuroblastoma

Affiliations

Clinical outcomes, Kadish-INSICA staging and therapeutic targeting of somatostatin receptor 2 in olfactory neuroblastoma

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Substances

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Medical