Survival predictors of 177 Lu-Dotatate peptide receptor radionuclide therapy (PRRT) in patients with progressive well-differentiated neuroendocrine tumors (NETS).

Autor: Swiha MM; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada. mina.swiha@lhsc.on.ca., Sutherland DEK; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada., Sistani G; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.; Medical Imaging Department, Division of Diagnostic Radiology, University of Western Ontario, London, ON, Canada., Khatami A; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada., Abazid RM; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada., Mujoomdar A; Medical Imaging Department, Division of Diagnostic Radiology, University of Western Ontario, London, ON, Canada., Wiseman DP; Medical Imaging Department, Division of Diagnostic Radiology, University of Western Ontario, London, ON, Canada., Romsa JG; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada., Reid RH; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada., Laidley DT; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
Jazyk: angličtina
Zdroj: Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2022 Jan; Vol. 148 (1), pp. 225-236. Date of Electronic Publication: 2021 Jun 10.
DOI: 10.1007/s00432-021-03672-w
Abstrakt: Purpose: 177 Lu-Dotatate is an emerging treatment modality for patients with unresectable or metastatic well-differentiated NETs. This study examines survival predictors in patients who received 177 Lu-Dotatate.
Methods: A retrospective single-center review was conducted, examining 47 individuals with progressive well-differentiated NETs treated with 177 Lu-Dotatate (four induction cycles of 5.5 GBq at 10-week intervals followed by eight maintenance cycles of 3.7 GBq at 6-month intervals).
Results: Median follow-up was 63.1 months with a median progression-free survival (PFS) of 34.1 months. However, median overall survival (OS) was not reached at the time of analysis. The presence of ≥ 5 bone metastases (hazard ratio HR 4.33; p = 0.015), non-gastroenteropancreatic (non-GEP) NETs (HR 3.22; p = 0.025) and development of interim ascites (HR 3.15; p = 0.047) independently predicted a worse OS. Patients with chromogranin A of ≥ 4 × upper limit of normal (ULN) had shorter OS (p < 0.001) and PFS (p = 0.004). Similarly, those with pre-existing ascites demonstrated a worse OS (p = 0.009) and PFS (p = 0.026). Liver metastases involving greater than 50% liver volume and the existence of unusual metastatic locations had a negative impact on OS (p = 0.033) and PFS (p = 0.026), respectively.
Conclusion: High burden of skeletal and hepatic metastases, non-GEP-NETs, chromogranin A of ≥ 4 × ULN, unusual metastatic sites, pre-existing and interim ascites are predictors of poor outcomes in patients treated with 177 Lu-Dotatate. These common indicators can be used for the risk stratification and identification of patients most likely to benefit from PRRT.
Trial Registration: ClinicalTrials.gov identifier: NCT02236910, Retrospectively registered on September, 2014.
(© 2021. The Author(s).)
Databáze: MEDLINE
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