Response, survival, and long-term toxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers
| Autor: | Philippe Brunner, Jan Müller-Brand, Helmut Rasch, Nicolas Marincek, Anna Imhof, Helmut R. Mäcke, Martin A. Walter, Christoph Rochlitz, Christian Schindler, Matthias Briel |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent Octreotide Neuroendocrine tumors Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Humans DOTA Yttrium Radioisotopes Neoplasm Metastasis Child Aged Aged 80 and over business.industry Hazard ratio Middle Aged medicine.disease 3. Good health Clinical trial Neuroendocrine Tumors Somatostatin Endocrinology Oncology chemistry Tumor progression 030220 oncology & carcinogenesis Toxicity Female Radiopharmaceuticals business medicine.drug |
| Zdroj: | J Clin Oncol |
| DOI: | 10.1200/JCO.2010.33.7873 |
| Popis: | Purpose To investigate response, survival, and safety profile of the somatostatin-based radiopeptide 90yttrium-labeled tetraazacyclododecane-tetraacetic acid modified Tyr-octreotide ([90Y-DOTA]-TOC) in neuroendocrine cancers. Patients and Methods In a clinical phase II single-center open-label trial, patients with neuroendocrine cancers were treated with repeated cycles of [90Y-DOTA]-TOC. Each cycle consisted of a single intravenous injection of 3.7GBq/m2 body-surface [90Y-DOTA]-TOC. Additional cycles were withheld in case of tumor progression and/or permanent toxicity. Results Overall, 1,109 patients received 2,472 cycles of [90Y-DOTA]-TOC (median, two; range, one to 10 cycles per patient). Of the 1,109 patients, 378 (34.1%) experienced morphologic response; 172 (15.5%), biochemical response; and 329 (29.7%), clinical response. During a median follow-up of 23 months, 491 patients (44.3%) died. Longer survival was correlated with each: morphologic (hazard ratio [HR], 0.46; 95% CI, 0.38 to 0.56; median survival, 44.7 v 18.3 months; P < .001), biochemical (HR, 0.75; 95% CI, 0.59 to 0.96; 35.3 v 25.7 months; P = .023), and clinical response (HR, 0.68; 95% CI, 0.56 to 0.82; 36.8 v 23.5 months; P < .001). Overall, 142 patients (12.8%) developed grade 3 to 4 transient hematologic toxicities, and 103 patients (9.2%) experienced grade 4 to 5 permanent renal toxicity. Multivariable regression revealed that tumoral uptake in the initial imaging study was predictive for overall survival (HR, 0.45; 95% CI, 0.29 to 0.69; P < .001), whereas the initial kidney uptake was predictive for severe renal toxicity (HR, 1.59; 95% CI, 1.17 to 2.17; P = .003). Conclusion This study documents the long-term outcome of [90Y-DOTA]-TOC treatment in a large cohort. Response to [90Y-DOTA]-TOC is associated with longer survival. Somatostatin receptor imaging is predictive for both survival after [90Y-DOTA]-TOC treatment and occurrence of renal toxicity. |
| Databáze: | OpenAIRE |
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