Radioligand therapy (RLT) used to treat cardiac metastasis of pancreatic neuroendocrine tumor

Abstract

Radioligand Therapy (RLT) in the form of [177Lu] Lu-DOTA-TATE (Lutathera®) is a promising treatment for pancreatic neuroendocrine tumors (pNETs) with cardiac metastasis. We present a patient treated with [177Lu] Lu-DOTA-TATE that showed shrinkage of metastasis after four treatments at 7.4 GBq every 8 weeks.

Keywords: Lutathera; cardiac metastases; neuroendocrine neoplasms (NENs); peptide receptor radiotherapy (PRRT); somatostatin receptor.

FIGURE 1

Imaging of a patient with metastatic pNET to the heart, treated with [177Lu] Lu‐DOTA‐TATE and lanreotide. (A, B) Cardiac magnetic resonance imaging (cMRI) with gadolinium (Gd) contrast showing our patient's cardiac metastases prior to treatment. The mass measured 15 mm x 23 mm and did not impact cardiac function (ejection fraction was estimated as 75%). Short axis (A) and axial (B) orientations are shown. (C) Positron emission tomography (PET) imaging with gallium (Ga)‐68 contrast taken prior to patient treatment showing hyperintensity at the same location as the mass seen in Figure 1A, B; intensity was measured at 27.4 standardized uptake units (SUV). (D) cMRI showing decreased lesion size compared to Figure 1A, B (now about 9 mm in diameter at widest point). (E) PET imaging after treatment with [177Lu] Lu‐DOTA‐TATE showing decreased uptake (now 24.8 SUV) compared to Figure 1C.