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Abstract​

Purpose:

Bronchial and gastroenteropancreatic neuroendocrine tumors (NET) are slow-growing tumors, which frequently express somatostatin receptors on their cell membranes. These receptors are targets for therapy with Lutetium-177-labeled somatostatin analogues. We have treated over 1,200 patients with peptide receptor radionuclide therapy (PRRT) with [177Lu-DOTA0,Tyr3]octreotate (177Lu-DOTATATE) since the year 2000 and present the results on efficacy, survival, and toxicity of this therapy.

Experimental Design: 

For safety analysis, 610 patients treated with a cumulative dose of at least 100 mCi (3.7 GBq) 177Lu-DOTATATE were included. A subgroup of 443 Dutch patients who were treated with a cumulative dose of at least 600 mCi (22.2 GBq) 177Lu-DOTATATE before 2013 was further analyzed for efficacy and survival.

Results:

The objective response rate of the total group of patients was 39%. Stable disease was reached in 43% of patients. Progression-free survival (PFS) and overall survival (OS) for all NET patients were 29 months [95% confidence interval (CI), 26-33 months] and 63 months (95% CI, 55-72 months). Long-term toxicity included acute leukemia in four patients (0.7%) and myelodysplastic syndrome in nine patients (1.5%). No therapy-related long-term renal or hepatic failure occurred.

Conclusions:

PRRT with 177Lu-DOTATATE is a favorable therapeutic option in patients with metastatic bronchial and gastroenteropancreatic NETs that express somatostatin receptors. PRRT with 177Lu-DOTATATE is safe with few side-effects and shows good response rates with PFS of 29 months and OS of 63 months.

Author information

Brabander T1, van der Zwan WA2, Teunissen JJM2, Kam BLR2, Feelders RA3, de Herder WW3, van Eijck CHJ4, Franssen GJH4, Krenning EP2, Kwekkeboom DJ2.

1 Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands. t.brabander@erasmusmc.nl.

2 Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands.

3 Department of Internal Medicine, Erasmus Medical Center, ENETS Center of Excellence, Rotterdam, the Netherlands.

4 Department of Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.