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Updated: Sep 26, 2026
A Practical Guide for the Production and PET/CT Imaging of 68Ga-DOTATATE for Neuroendocrine Tumors in Daily Clinical Practice
Published on: April 17, 2019
90Y-DOTA-D-Phe1-Try3-octreotide in therapy of neuroendocrine malignancies
G Paganelli1, L Bodei, D Handkiewicz Junak
1Division of Nuclear Medicine-European Institute of Oncology, Milano, Italy. direzione.mnu@ieo.it
Abstract:
Somatostatin receptors type 2 (sst(2)) are expressed in high concentration on numerous neudoendocrine tumors. The successful use of radiolabeled somatostatin analogs in imaging promoted further studies in utilizing them in radiopeptide therapy. The somatostatin analog [(90)Y-DOTA-D-Phe(1)-Try3]octreotide (DOTATOC) (DOTA: 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid) possesses favorable characteristic for its therapeutic use; shows high affinity for sst(2), moderately high affinity for sst(5), and intermediate affinity for sst(3); high hydrophilicity; stable and facile labeling with (111) In and (90) Y. In this article we report our experience with (90)Y-DOTATOC in neuroendocrine tumors. Eighty-seven patients with neuroendocrine tumors were treated with a cumulated activity ranging from 7.4 to 20.2 GBq. Most patients responded with stabilization of disease (48%); however, objective responses were observed in 28% of patients (5% complete response). No major acute reactions were observed up to the activity of 5.55 GBq per cycle. The dose limiting was bone marrow toxicity and the maximal tolerated dose was defined as 5.18 GBq.
Insights
Radiopeptide therapy using Yttrium-90 labeled somatostatin analog (90)Y-DOTATOC showed disease stabilization in 48% of neuroendocrine tumor patients. Bone marrow toxicity was the dose-limiting factor, with a maximal tolerated dose of 5.18 GBq.
Area of Science:
- Oncology
- Nuclear Medicine
- Endocrinology
Background:
- Somatostatin receptors type 2 (sst(2)) are highly expressed in neuroendocrine tumors.
- Radiolabeled somatostatin analogs are effective for imaging and are being explored for radiopeptide therapy.
- The somatostatin analog (90)Y-DOTATOC exhibits favorable characteristics for therapeutic application.
Purpose of the Study:
- To report the clinical experience with (90)Y-DOTATOC radiopeptide therapy in patients with neuroendocrine tumors.
- To evaluate the efficacy and safety of (90)Y-DOTATOC in this patient cohort.
Main Methods:
- Eighty-seven patients with neuroendocrine tumors were treated with (90)Y-DOTATOC.
- Cumulated activities ranged from 7.4 to 20.2 GBq.
- Patient responses and adverse events were monitored.
Main Results:
- Disease stabilization was observed in 48% of patients.
- Objective responses, including 5% complete responses, were seen in 28% of patients.
- No major acute reactions occurred up to 5.55 GBq per cycle, with bone marrow toxicity being dose-limiting.
Conclusions:
- (90)Y-DOTATOC demonstrates therapeutic potential in neuroendocrine tumors, offering disease stabilization and objective responses.
- The maximal tolerated dose was determined to be 5.18 GBq due to bone marrow toxicity.
- Further investigation into optimizing dosimetry and patient selection is warranted.
