Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center
Introduction: Functioning neuroendocrine tumors (NETs) that do not respond to standard therapies are commonly considered for Peptide Receptor Radionuclide Therapy (PRRT). The benefit of 177Lu-DOTATATE PRRT in patients with progressive metastatic NET was analyzed and survival in multi-organ involveme...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Indian Journal of Endocrinology and Metabolism |
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| Online Access: | https://journals.lww.com/10.4103/ijem.ijem_372_23 |
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| author | David Mathew Saumya S. Sunny Justin Benjamin Junita R. John Felix K. Jebasingh Josh T. Georgy Ashish Singh Regi Oommen |
| author_facet | David Mathew Saumya S. Sunny Justin Benjamin Junita R. John Felix K. Jebasingh Josh T. Georgy Ashish Singh Regi Oommen |
| author_sort | David Mathew |
| collection | DOAJ |
| description | Introduction:
Functioning neuroendocrine tumors (NETs) that do not respond to standard therapies are commonly considered for Peptide Receptor Radionuclide Therapy (PRRT). The benefit of 177Lu-DOTATATE PRRT in patients with progressive metastatic NET was analyzed and survival in multi-organ involvement.
Methods:
Forty-one patients with refractory, progressive, or advanced symptomatic NETs, with or without previous treatment modalities were studied. They were treated with 177Lu-DOTATATE IV infusion 150 mCi per dose up to four cycles. Retrospectively, they were assessed for response to PRRT based on clinical, Imaging-Contrast CT/68Ga-DOTATATE PET-CT, and biochemical markers. After treatment, classification based on disease status, symptomatic improvement, and response to treatment based on Chromogranin A level was done. The organs involved and their respective survival benefits, as estimated by Kaplan Meier, were plotted for 60 months.
Results:
The mean serum Chromogranin A level at baseline was 2841 U/ml (Median = 3150). The main site of primary NET was in the pancreas, and the most common site for metastases was the liver. Following PRRT, all patients, except one, reported an improvement in their baseline complaints. Most (82%) reported no new symptoms, and 50% had a reduction in serum Chromogranin A levels. Follow-up imaging showed regression in one patient, static tumor in 18, and progression in rest. Considering radiological and clinical responses, the overall benefit was noticed in 29 (70%) patients. Despite symptomatic improvement, there was no significant survival benefit for those with pancreatic, liver, or nodal metastasis.
Conclusion:
A majority of patients who were treated with PRRT demonstrated clinical, radiological as well as biochemical positive responses warranting an earlier consideration for this well-tolerated treatment modality. |
| format | Article |
| id | doaj-art-7e4a223bb5d34dcc92a0555cba45563d |
| institution | Kabale University |
| issn | 2230-8210 2230-9500 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj-art-7e4a223bb5d34dcc92a0555cba45563d2025-01-09T12:23:25ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102230-95002024-12-0128660161010.4103/ijem.ijem_372_23Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care CenterDavid MathewSaumya S. SunnyJustin BenjaminJunita R. JohnFelix K. JebasinghJosh T. GeorgyAshish SinghRegi OommenIntroduction: Functioning neuroendocrine tumors (NETs) that do not respond to standard therapies are commonly considered for Peptide Receptor Radionuclide Therapy (PRRT). The benefit of 177Lu-DOTATATE PRRT in patients with progressive metastatic NET was analyzed and survival in multi-organ involvement. Methods: Forty-one patients with refractory, progressive, or advanced symptomatic NETs, with or without previous treatment modalities were studied. They were treated with 177Lu-DOTATATE IV infusion 150 mCi per dose up to four cycles. Retrospectively, they were assessed for response to PRRT based on clinical, Imaging-Contrast CT/68Ga-DOTATATE PET-CT, and biochemical markers. After treatment, classification based on disease status, symptomatic improvement, and response to treatment based on Chromogranin A level was done. The organs involved and their respective survival benefits, as estimated by Kaplan Meier, were plotted for 60 months. Results: The mean serum Chromogranin A level at baseline was 2841 U/ml (Median = 3150). The main site of primary NET was in the pancreas, and the most common site for metastases was the liver. Following PRRT, all patients, except one, reported an improvement in their baseline complaints. Most (82%) reported no new symptoms, and 50% had a reduction in serum Chromogranin A levels. Follow-up imaging showed regression in one patient, static tumor in 18, and progression in rest. Considering radiological and clinical responses, the overall benefit was noticed in 29 (70%) patients. Despite symptomatic improvement, there was no significant survival benefit for those with pancreatic, liver, or nodal metastasis. Conclusion: A majority of patients who were treated with PRRT demonstrated clinical, radiological as well as biochemical positive responses warranting an earlier consideration for this well-tolerated treatment modality.https://journals.lww.com/10.4103/ijem.ijem_372_2368ga-dotatatekaplan–meier survival estimates177lu-dotatatenetneuroendocrine tumorpeptide receptor radionuclide therapyprrt |
| spellingShingle | David Mathew Saumya S. Sunny Justin Benjamin Junita R. John Felix K. Jebasingh Josh T. Georgy Ashish Singh Regi Oommen Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center Indian Journal of Endocrinology and Metabolism 68ga-dotatate kaplan–meier survival estimates 177lu-dotatate net neuroendocrine tumor peptide receptor radionuclide therapy prrt |
| title | Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center |
| title_full | Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center |
| title_fullStr | Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center |
| title_full_unstemmed | Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center |
| title_short | Outcome of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in Progressive Metastatic Neuroendocrine Tumors from a Tertiary Care Center |
| title_sort | outcome of 177lu dotatate peptide receptor radionuclide therapy in progressive metastatic neuroendocrine tumors from a tertiary care center |
| topic | 68ga-dotatate kaplan–meier survival estimates 177lu-dotatate net neuroendocrine tumor peptide receptor radionuclide therapy prrt |
| url | https://journals.lww.com/10.4103/ijem.ijem_372_23 |
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