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A Whole Body Dosimetry Protocol for Peptide-Receptor Radionuclide Therapy PRRT: 2D Planar Image and Hybrid 2D+3D SPECT/CT Image Methods
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Peptide Receptor Radionuclide Therapy in Thyroid Cancer

Sriram Gubbi1, Christian A Koch2,3, Joanna Klubo-Gwiezdzinska1

  • 1Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States.

Frontiers in Endocrinology
|June 17, 2022
PubMed

Insights

Peptide receptor radionuclide therapy (PRRT) shows promise for treating advanced, radioactive iodine-refractory thyroid cancers. This targeted therapy may offer a safer alternative to current treatments for differentiated thyroid cancers (DTCs) and medullary thyroid cancers (MTCs).

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmaceutical Therapy

Background:

  • Limited treatment options exist for metastatic, progressive radioactive iodine (RAI)-refractory differentiated thyroid cancers (DTCs) and medullary thyroid cancers (MTCs).
  • Current systemic targeted therapies, like tyrosine kinase inhibitors, carry risks of severe adverse events.
  • Peptide receptor radionuclide therapy (PRRT) presents a potential alternative for managing these challenging thyroid cancers.

Purpose of the Study:

  • To review the current translational and clinical data on the use of PRRT in RAI-refractory DTCs and MTCs.
  • To explore the diagnostic and theranostic applications of PRRT in thyroid cancer management.
  • To identify future research directions for PRRT in thyroid oncology.

Main Methods:

  • Comprehensive literature review of translational and clinical studies on PRRT for thyroid cancer.
  • Analysis of data on somatostatin receptor (SSTR) expression in DTCs and MTCs.
  • Evaluation of PRRT efficacy and safety in specific thyroid cancer subtypes.

Main Results:

  • PRRT demonstrates potential efficacy and safety in treating SSTR+ RAI-refractory DTCs and MTCs.
  • Favorable responses to PRRT observed in MTCs and Hürthle cell cancers, which are less responsive to conventional treatments.
  • Diagnostic utility of somatostatin analogs and theranostic properties of PRRT highlighted.

Conclusions:

  • PRRT is a promising therapeutic modality for select patients with advanced, RAI-refractory thyroid cancers.
  • Further research, including head-to-head comparisons with existing therapies, is warranted to optimize PRRT utilization.
  • PRRT offers a potential new avenue for managing difficult-to-treat thyroid malignancies.
Keywords:
DOTATATEPRRTmedullary thyroid cancer (MTC)somatostatin receptorthyroid cancer

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