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177Lu-DOTATATE Therapy in Radioiodine-refractory Differentiated Thyroid Cancer: A Single Center Experience

Wolfgang Roll, Burkhard Riemann, Michael Schäfers

    Clinical Nuclear Medicine
    |July 31, 2018
    PubMed
    Abstract

    Insights

    Radioiodine-refractory differentiated thyroid cancer (RrDTC) patients receiving Lutetium-DOTATATE (Lu-DOTATATE) showed limited efficacy. Despite somatostatin receptor expression, only one of five patients responded, indicating heterogeneous outcomes for this novel theranostic option.

    Area of Science:

    • Nuclear Medicine
    • Oncology
    • Radiopharmacology

    Background:

    • Radioiodine-refractory differentiated thyroid cancer (RrDTC) presents a poor prognosis.
    • Novel therapeutic strategies are crucial for RrDTC management.
    • Somatostatin receptor (SSRT) expression in some RrDTCs offers a potential therapeutic target.

    Purpose of the Study:

    • To evaluate the efficacy of Lutetium-DOTATATE (Lu-DOTATATE) peptide receptor radionuclide therapy (PRRT) in RrDTC patients.
    • To assess the theranostic potential of targeting SSRTs in RrDTC.

    Main Methods:

    • Five RrDTC patients with SSRT expression (confirmed by Ga-DOTATATE-PET/CT) received 2-4 cycles of Lu-DOTATATE PRRT.
    • Treatment response was evaluated using thyroglobulin levels and imaging (Ga-DOTATATE-PET/CT) criteria.
    • Per-patient analysis was conducted to assess outcomes.

    Main Results:

    • One out of five patients achieved a partial response.
    • Three patients experienced progressive disease.
    • One patient showed stable imaging but rising thyroglobulin levels, indicating discordant response.

    Conclusions:

    • Lu-DOTATATE PRRT demonstrated heterogeneous response and limited efficacy in this cohort of RrDTC patients.
    • Despite pre-therapeutic SSRT expression and uptake, clinical benefit was inconsistent.
    • Further research is needed to optimize theranostic approaches for RrDTC.

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