Efficacy of [ 177 Lu]Lu-DOTATATE in metastatic neuroendocrine neoplasms of different locations: data from the SEPTRALU study.

Autor: Mitjavila M; Department of Nuclear Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain., Jimenez-Fonseca P; Department of Medical Oncology, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain., Belló P; Department of Nuclear Medicine, Hospital Universitario La Fe, Valencia, Spain., Pubul V; Department of Nuclear Medicine, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain., Percovich JC; Department of Endocrinology and Nutrition, Hospital Universitario Gregorio Marañón, Madrid, Spain., Garcia-Burillo A; Department of Nuclear Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain., Hernando J; Department of Medical Oncology, Hospital Universitario Vall d'Hebron, Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain., Arbizu J; Department of Nuclear Medicine, Clínica Universidad de Navarra, Pamplona, Spain., Rodeño E; Department of Nuclear Medicine, Hospital Universitario de Cruces, Bilbao, Spain., Estorch M; Department of Nuclear Medicine, Hospital de la Santa Creu i San Pau, Barcelona, Spain., Llana B; Department of Nuclear Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain., Castellón M; Department of Nuclear Medicine, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain., García-Cañamaque L; Department of Nuclear Medicine, Hospital HM Sanchinarro, Madrid, Spain., Gajate P; Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain., Riesco MC; Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain., Miguel MB; Department of Nuclear Medicine, Hospital Universitario de Burgos, Burgos, Spain., Balaguer-Muñoz D; Department of Nuclear Medicine, Hospital Universitario Doctor Peset, Valencia, Spain., Custodio A; Department of Medical Oncology, Hospital Universitario La Paz, CIBERONC CB16/12/00398, Madrid, Spain., Cano JM; Department of Medical Oncology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain., Repetto A; Department of Nuclear Medicine, Hospital Universitario Son Espases, Mallorca, Spain., Garcia-Alonso P; Department of Nuclear Medicine, Hospital Universitario de Getafe, Madrid, Spain., Muros MA; Department of Nuclear Medicine, Hospital Universitario Virgen de las Nieves, Granada, Spain., Vercher-Conejero JL; Department of Nuclear Medicine-PET Unit, Hospital Universitario de Bellvitge - IDIBELL, Barcelona, Spain., Carmona-Bayonas A; Department of Medical Oncology, Hospital Universitario Morales Meseguer, University de Murcia, IMIB, Murcia, Spain. alberto.carmonabayonas@gmail.com.
Jazyk: angličtina
Zdroj: European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2023 Jul; Vol. 50 (8), pp. 2486-2500. Date of Electronic Publication: 2023 Mar 06.
DOI: 10.1007/s00259-023-06166-8
Abstrakt: Background: Peptide receptor radionuclide therapy (PRRT) is one of the most promising therapeutic strategies in neuroendocrine neoplasms (NENs). Nevertheless, its role in certain tumor sites remains unclear. This study sought to elucidate the efficacy and safety of [ 177 Lu]Lu-DOTATATE in NENs with different locations and evaluate the effect of the tumor origin, bearing in mind other prognostic variables. Advanced NENs overexpressing somatostatin receptors (SSTRs) on functional imaging, of any grade or location, treated at 24 centers were enrolled. The protocol consisted of four cycles of 177 Lu-DOTATATE 7.4 GBq iv every 8 weeks (NCT04949282).
Results: The sample comprised 522 subjects with pancreatic (35%), midgut (28%), bronchopulmonary (11%), pheochromocytoma/ paraganglioma (PPGL) (6%), other gastroenteropancreatic (GEP) (11%), and other non-gastroenteropancreatic (NGEP) (9%) NENs. The best RECIST 1.1 responses were complete response, 0.7%; partial response, 33.2%; stable disease, 52.1%; and tumor progression, 14%, with activity conditioned by the tumor subtype, but with benefit in all strata. Median progression-free survival (PFS) was 31.3 months (95% CI, 25.7-not reached [NR]) in midgut, 30.6 months (14.4-NR) in PPGL, 24.3 months (18.0-NR) in other GEP, 20.5 months (11.8-NR) in other NGEP, 19.8 months (16.8-28.1) in pancreatic, and 17.6 months (14.4-33.1) in bronchopulmonary NENs. [ 177 Lu]Lu-DOTATATE exhibited scant severe toxicity.
Conclusion: This study confirms the efficacy and safety of [ 177 Lu]Lu-DOTATATE in a wide range of SSTR-expressing NENs, regardless of location, with clinical benefit and superimposable survival outcomes between pNENs and other GEP and NGEP tumor subtypes different from midgut NENs.
(© 2023. The Author(s).)
Databáze: MEDLINE
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