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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
Treatment and Long-Term Safety Outcomes of Peptide Receptor Radionuclide Therapy for Metastatic Neuroendocrine
Wei Ying Tham1, Hian Liang Huang1, David Wai Meng Tai2
1Singapore General Hospital, Department of Nuclear Medicine and Molecular Imaging, Singapore, Singapore.
Purpose:
Peptide receptor radionuclide therapy (PRRT) is a targeted molecular therapy used to treat neuroendocrine tumours (NETs). It has been shown to be effective and well tolerated in patients with metastatic NETs in several centres in the USA, Europe, and Australia. Tolerability and efficacy data emerging from Asian centres remain few. Epidemiological evidence suggests that there are differences in neuroendocrine neoplasms between the population groups. We aim to describe the treatment and safety outcomes of PRRT in the Asian population.
Methods:
One hundred and seven (107) patients with metastatic NETs who had undergone PRRT treatment from January 2012 to March 2019 were included in this retrospective study. The response rates using RECIST 1.1 and qualitative analysis were examined. The overall and progression-free survival curves were also evaluated.
Results:
The median progression-free survival was 49 months. Response assessment after completion of treatment showed that 33 (37.9%) of 87 patients had partial or complete response. Subgroup analysis comparing high- and low-grade NET showed that there was a significant difference in the time to progression curves. Comparison of the number of cycles and progression-free and overall survival also showed a significant difference. Ten patients (9%) had grade 3 or more haematological toxicities. Four patients (4%) had grade 3/4 hepatobiliary toxicities, although the presence of extensive liver metastases was a confounding factor. None of the patients had grade 3/4 acute kidney injury.
Conclusion:
Our results show that PRRT is safe and effective in the treatment of metastatic NET in the Asian population. There was a significant difference in the progression-free survival curves between low-grade and high-grade NET and in the progression-free and overall survival comparing the number of cycles received.
Insights
Peptide receptor radionuclide therapy (PRRT) is safe and effective for metastatic neuroendocrine tumors (NETs) in Asian patients. Outcomes like progression-free survival varied significantly based on tumor grade and treatment cycles received.
Area of Science:
- Oncology
- Nuclear Medicine
- Pharmacology
Background:
- Neuroendocrine tumors (NETs) are a diverse group of neoplasms.
- Peptide receptor radionuclide therapy (PRRT) is an established treatment for metastatic NETs.
- Limited data exist on PRRT efficacy and safety in Asian populations.
Purpose of the Study:
- To evaluate the treatment outcomes of PRRT in Asian patients with metastatic NETs.
- To assess the safety profile of PRRT in this demographic.
- To explore potential differences in NET behavior and treatment response in Asian populations.
Main Methods:
- Retrospective analysis of 107 patients with metastatic NETs treated with PRRT (January 2012 - March 2019).
- Evaluation of response rates using RECIST 1.1 and qualitative analysis.
- Assessment of progression-free survival (PFS) and overall survival (OS).
Main Results:
- Median PFS was 49 months.
- 37.9% of patients achieved partial or complete response.
- Significant differences in PFS observed between high- and low-grade NETs, and by number of PRRT cycles received.
- Grade 3/4 toxicities included hematological (9%) and hepatobiliary (4%).
Conclusions:
- PRRT demonstrates safety and efficacy in Asian patients with metastatic NETs.
- Tumor grade and number of treatment cycles are significant factors influencing PFS and OS.
- Further research is warranted to understand population-specific differences in NETs and PRRT response.
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