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Case Report: Re-Treatment With Lu-DOTATATE in Neuroendocrine Tumors
Elena María Vida Navas1, Alberto Martínez Lorca2, Aintzane Sancho Gutiérrez3
1Medical Oncology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.
Frontiers in Endocrinology
|May 3, 2021
Summary
Salvage peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE offers a viable treatment option for advanced neuroendocrine tumors (NETs) progressing after initial therapies. Retreatment demonstrates efficacy and manageable toxicity in NET patients.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiopharmacology
Background:
- Peptide receptor radionuclide therapy (PRRT) is a standard treatment for advanced neuroendocrine tumors (NETs) expressing somatostatin receptors.
- Limited therapeutic options exist for NETs after disease progression.
- Salvage therapy with PRRT is being explored for advanced NETs.
Observation:
- A case report details a 26-year-old male with advanced NET, initially treated with lanreotide, everolimus, and sunitinib.
- Initial 177Lu-DOTATATE therapy resulted in a 38-month progression-free survival (PFS).
- Following progression, re-treatment with 177Lu-DOTATATE achieved a partial response, stable for 15 months with minimal toxicity.
Findings:
- Salvage PRRT with 177Lu-DOTATATE shows efficacy in advanced NETs post-progression.
- Median PFS for salvage PRRT ranges from 6 to 22 months.
- Reported toxicities are primarily hematologic (anemia, neutropenia), with 4-7% experiencing grade 3/4 events.
Implications:
- Re-treatment with 177Lu-DOTATATE represents a promising salvage strategy for NET patients.
- Evidence supports the efficacy and low toxicity of salvage PRRT, despite a lack of phase III trials.
- Further research may establish consensus on dosing and cycles for salvage PRRT in NET management.
