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Updated: Aug 23, 2026
Pretargeted Radioimmunotherapy Based on the Inverse Electron Demand Diels-Alder Reaction
Published on: January 29, 2019
Targeted radiotherapy for small cell lung cancer using 90Yttrium-DOTATOC, an Yttrium-labelled somatostatin analogue:
Miklos Pless1, Christian Waldherr, Helmut Maecke
1Division of Medical Oncology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. mpless@uhbs.ch
Background:
Some small cell lung carcinomas (SCLC) express neuro-endocrine markers, such as somatostatin receptors. Therefore, somatostatin analogues can be radio-labelled with 111Indium (Octreoscan) for diagnostic scintigraphy, or with 90Y-DOTATOC for therapeutic use. This is the first trial to assess the toxicity and efficacy of treatment with 90Y-DOTATOC in patients with Octreoscan positive SCLC.
Methods:
Patients with SCLC after > or =first line chemotherapy received an Octreoscan scintigraphy and results were compared to CT scans. Patients with strong somatostatin-receptor expression were treated with 60 mCi/m2 90Y-DOTATOC i.v. every 3 weeks, for a total of three cycles. Major inclusion criteria were measurable tumour lesions, disease progression, normal creatinine clearance, PS < or = 2.
Results:
Octreoscan scintigraphy identified 70% of all primary tumours, 87% of all mediastinal lesions, but only 26% of all extrathoracic tumour manifestations. Six patients were treated. Median number of 90Y-DOTATOC cycles was 2 (1-3). The only grade 3 toxicity was fatigue (n = 2) and dyspnea (n = 1). There were no severe renal or haematological toxicities. All six patients had tumour progression, median progression free survival (PFS) was 37.5 days (28-52) and median overall (OS) was 103.5 days (28-269).
Conclusion:
This is the first report of somatostatin-receptor targeted radiotherapy for SCLC in the literature. In contrast to well differentiated neuro-endocrine tumours, 90Y-DOTATOC seems to be inactive in SCLC.
Insights
This study investigated 90Y-DOTATOC therapy for small cell lung cancer (SCLC) patients with somatostatin receptor expression. The treatment showed limited efficacy and short progression-free survival in SCLC, unlike in other neuroendocrine tumors.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiotherapy
Background:
- Small cell lung carcinoma (SCLC) can express neuroendocrine markers, including somatostatin receptors.
- Somatostatin analogues, radio-labeled as Octreoscan for diagnostics or 90Y-DOTATOC for therapy, are used in neuroendocrine tumors.
- This study is the first to evaluate 90Y-DOTATOC treatment for Octreoscan-positive SCLC.
Purpose of the Study:
- To assess the toxicity and efficacy of 90Y-DOTATOC radiotherapy in patients with SCLC.
- To evaluate the diagnostic accuracy of Octreoscan scintigraphy compared to CT scans in SCLC patients.
- To determine progression-free survival (PFS) and overall survival (OS) following 90Y-DOTATOC treatment.
Main Methods:
- Patients with SCLC and disease progression after first-line chemotherapy underwent Octreoscan scintigraphy.
- Eligible patients with strong somatostatin receptor expression received 90Y-DOTATOC (60 mCi/m2) intravenously every 3 weeks for three cycles.
- Inclusion criteria included measurable disease, normal renal function, and performance status <= 2.
Main Results:
- Octreoscan identified 70% of primary tumors and 87% of mediastinal lesions, but only 26% of extrathoracic metastases.
- Six patients were treated, receiving a median of 2 cycles.
- Grade 3 toxicities included fatigue and dyspnea; no severe renal or hematological toxicity occurred. All patients experienced disease progression, with a median PFS of 37.5 days and median OS of 103.5 days.
Conclusions:
- 90Y-DOTATOC radiotherapy for SCLC is reported for the first time.
- The study suggests that 90Y-DOTATOC is inactive in SCLC, contrasting with its efficacy in well-differentiated neuroendocrine tumors.
- Further research may be needed to explore alternative targeted therapies for SCLC.
