Neuroendocrinology
Original Paper
Peptide Receptor Radionuclide Therapy with 90Y-DOTATOC and 177Lu-DOTATOC in Advanced Neuroendocrine Tumors: Results from a Danish Cohort Treated in SwitzerlandPfeifer A.K.a, d · Gregersen T.e · Grønbæk H.e · Hansen C.P.b, d · Müller-Brand J.f · Herskind Bruun K.c, d · Krogh K.e · Kjær A.a, d · Knigge U.b, dDepartments of aClinical Physiology, Nuclear Medicine and PET, bAbdominal Surgery C and cOncology, and dCenter of Excellence for Neuroendocrine Tumors, Rigshospitalet, Faculty of Health Sciences, University of Copenhagen, Copenhagen, and eDepartment of Medicine V, Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; fInstitute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
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Article / Publication Details
Received: July 15, 2010
Accepted: February 01, 2011
Published online: February 19, 2011
Issue release date: April 2011
Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 5
ISSN: 0028-3835 (Print)
eISSN: 1423-0194 (Online)
For additional information: https://www.karger.com/NEN
Abstract
Aim: Limited therapeutic options have highlighted the demand for new treatment modalities for patients with advanced neuroendocrine tumors (NET). Promising results of initial studies have warranted the implementation of peptide receptor radionuclide therapy (PRRT) in clinical practice. However, this treatment option still needs clinical evaluation. Methods: In this study, we evaluated the PRRT treatment response of 69 Danish patients with NET mainly originating from the gastroenteropancreatic system. Fifty-six patients (81%) were referred for PRRT to the Department of Nuclear Medicine, University Hospital Basel, Switzerland, between 2004 and 2008 due to progression assessed by the referring physicians. However, when retrospectively evaluated, only 42 of the 69 patients (61%) had progression according to RECIST (Response Evaluation Criteria in Solid Tumors). Most patients were treated with 90Y-DOTATOC. Results: Based on RECIST, a complete response was observed in 5 patients (7.4%), a partial response in 11 patients (16.2%) and stable disease in 42 patients (61.8%). Progressive disease after completed therapy was observed in 10 patients (14.7%). The median progression-free survival was 29 months (95% CI: 22–36 months). Pancreatic NET seemed to respond better to PRRT than small intestinal carcinoid tumors (p = 0.03). The overall frequency of serious adverse events was low. Conclusion: Implementation of PRRT in clinical routine has provided a valuable new therapeutic option for the treatment of advanced NET. We suggest that PRRT may advance from second- or third-line to first- or second-line therapy in inoperable/unresectable NET patients.
© 2011 S. Karger AG, Basel
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References
- Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, Abdalla EK, Fleming JB, Vauthey JN, Rashid A, Evans DB: One hundred years after ‘carcinoid’: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol 2008;26:3063–3072.
- Levi F, Te VC, Randimbison L, Rindi G, la Vecchia C: Epidemiology of carcinoid neoplasms in Vaud, Switzerland, 1974–97. Br J Cancer 2000;83:952–955.
- Quaedvlieg PF, Visser O, Lamers CB, Janssen-Heijen ML, Taal BG: Epidemiology and survival in patients with carcinoid disease in The Netherlands: an epidemiological study with 2,391 patients. Ann Oncol 2001;12:1295–1300.
- Hemminki K, Li X: Incidence trends and risk factors of carcinoid tumors: a nationwide epidemiologic study from Sweden. Cancer 2001;92:2204–2210.
- Ahlman H, Wängberg B, Jansson S, Friman S, Olausson M, Tylén U, Nilsson O: Interventional treatment of gastrointestinal neuroendocrine tumours. Digestion 2000;62(suppl 1):59–68.
- Janson ET, Sørbye H, Welin S, Federspiel B, Grønbæk H, Hellman P, Mathisen O, Mortensen J, Sundin A, Thiis-Evensen E, Välimäki MJ, Oberg K, Knigge U: Nordic Guidelines 2010 for diagnosis and treatment of gastroenteropancreatic neuroendocrine tumours. Acta Oncol 2010;49:740–756.
- Eriksson B, Renstrup J, Imam H, Oberg K: High-dose treatment with lanreotide of patients with advanced neuroendocrine gastrointestinal tumors: clinical and biological effects. Ann Oncol 1997;8:1041–1044.
- Ricci S, Antonuzzo A, Galli L, Ferdeghini M, Bodei L, Orlandini C, Conte PF: Octreotide acetate long-acting release in patients with metastatic neuroendocrine tumors pretreated with lanreotide. Ann Oncol 2000;11:1127–1130.
- Oberg K, Eriksson B: The role of interferons in the management of carcinoid tumours. Br J Haematol 1991;79(suppl 1):74–77.
- Plöckinger U, Wiedenmann B: Neuroendocrine tumors: biotherapy. Best Pract Res Clin Endocrinol Metab 2007;21:145–162.
- Oberg K: Chemotherapy and biotherapy in the treatment of neuroendocrine tumours. Ann Oncol 2001;12(suppl 2):S111–S114.
- Reubi JC, Laissue J, Krenning E, Lamberts SW: Somatostatin receptors in human cancer: incidence, characteristics, functional correlates and clinical implications. J Steroid Biochem Mol Biol 1992;43:27–35.
- Reubi JC: Peptide receptor expression in GEP-NET. Virchows Arch 2007;451(suppl 1):S47–S50.
- Kwekkeboom DJ, Müller-Brand J, Paganelli G, Anthony LB, Pauwels S, Kvols LK, O’Dorisio TM, Valkema R, Bodei L, Chinol M, Maecke HR, Krenning EP: Overview of results of peptide receptor radionuclide therapy with 3 radiolabeled somatostatin analogs. J Nucl Med 2005;46(suppl 1):62S–66S.
- Forrer F, Waldherr C, Maecke HR, Müller-Brand J: Targeted radionuclide therapy with 90Y-DOTATOC in patients with neuroendocrine tumors. Anticancer Res 2006;26:703–707.
- Valkema R, Pauwels S, Kvols LK, Barone R, Jamar F, Bakker WH, Kwekkeboom DJ, Bouterfa H, Krenning EP: Survival and response after peptide receptor radionuclide therapy with [90Y-DOTA0,Tyr3]octreotide in patients with advanced gastroenteropancreatic neuroendocrine tumors. Semin Nucl Med 2006;36:147–156.
- Kwekkeboom DJ, de Herder WW, Kam BL, van Eijck CH, van Essen M, Kooij PP, Feelders RA, van Aken MO, Krenning EP: Treatment with the radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol 2008;26:2124–2130.
- Frilling A, Weber F, Saner F, Bockisch A, Hofmann M, Müller-Brand J, Broelsch CE: Treatment with 90Y- and 177Lu-DOTATOC in patients with metastatic neuroendocrine tumors. Surgery 2006;140:968–977.
- Forrer F, Uusijarvi H, Storch D, Maecke HR, Müller-Brand J: Treatment with 177Lu-DOTATOC of patients with relapse of neuroendocrine tumors after treatment with 90Y-DOTATOC. J Nucl Med 2005;46:1310–1316.
- Rindi G, Klöppel G, Alhman H, Caplin M, Couvelard A, de Herder WW, Erikssson B, Falchetti A, Falconi M, Komminoth P, Körner M, Lopes JM, McNicol AM, Nilsson O, Perren A, Scarpa A, Scoazec JY, Wiedenmann B: TNM staging of foregut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2006;449:395–401.
- Rindi G, Klöppel G, Couvelard A, Komminoth P, Körner M, Lopes JM, McNicol AM, Nilsson O, Perren A, Scarpa A, Scoazec JY, Wiedenmann B: TNM staging of midgut and hindgut (neuro)endocrine tumors: a consensus proposal including a grading system. Virchows Arch 2007;451:757–762.
- Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, Verweij J, van Glabbeke M, van Oosterom AT, Christian MC, Gwyther SG: New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 2000;92:205–216.
- Nikou GC, Marinou K, Thomakos P, Papageorgiou D, Sanzanidis V, Nikolaou P, Kosmidis C, Moulakakis A, Mallas E: Chromogranin A levels in diagnosis, treatment and follow-up of 42 patients with non-functioning pancreatic endocrine tumours. Pancreatology 2008;8:510–519.
- Børglum T, Rehfeld JF, Drivsholm LB, Hilsted L: Processing-independent quantitation of chromogranin A in plasma from patients with neuroendocrine tumors and small-cell lung carcinomas. Clin Chem 2007;53:438–446.
- Mårtensson J, Groth S, Rehling M, Gref M: Chromium-51-EDTA clearance in adults with a single-plasma sample. J Nucl Med 1998;39:2131–2137.
- Bodei L, Cremonesi M, Grana C, Rocca P, Bartolomei M, Chinol M, Paganelli G: Receptor radionuclide therapy with 90Y-[DOTA]0-Tyr3-octreotide (90Y-DOTATOC) in neuroendocrine tumours. Eur J Nucl Med Mol Imaging 2004;31:1038–1046.
- Bodei L, Cremonesi M, Ferrari M, Pacifici M, Grana CM, Bartolomei M, Baio SM, Sansovini M, Paganelli G: Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors. Eur J Nucl Med Mol Imaging 2008;35:1847–1856.
- Valkema R, Pauwels SA, Kvols LK, Kwekkeboom DJ, Jamar F, de Jong M, Barone R, Walrand S, Kooij PP, Bakker WH, Lasher J, Krenning EP: Long-term follow-up of renal function after peptide receptor radiation therapy with 90Y-DOTA0,Tyr3-octreotide and 177Lu-DOTA0,Tyr3-octreotate. J Nucl Med 2005;46(suppl 1):83S–91S.
- Furlan D, Cerutti R, Uccella S, la Rosa S, Rigoli E, Genasetti A, Capella C: Different molecular profiles characterize well-differentiated endocrine tumors and poorly differentiated endocrine carcinomas of the gastroenteropancreatic tract. Clin Cancer Res 2004;10:947–957.
- Rorstad O: Prognostic indicators for carcinoid neuroendocrine tumors of the gastrointestinal tract. J Surg Oncol 2005;89:151–160.
- Seregni E, Ferrari L, Bajetta E, Martinetti A, Bombardieri E: Clinical significance of blood chromogranin A measurement in neuroendocrine tumours. Ann Oncol 2001;12(suppl 2):S69–S72.
Article / Publication Details
Received: July 15, 2010
Accepted: February 01, 2011
Published online: February 19, 2011
Issue release date: April 2011
Number of Print Pages: 8
Number of Figures: 1
Number of Tables: 5
ISSN: 0028-3835 (Print)
eISSN: 1423-0194 (Online)
For additional information: https://www.karger.com/NEN
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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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