Possible changes in glucose metabolism induced by radioligand therapy in patients with neuroendocrine neoplasms

Neuroendocrine neoplasms (NENs) belong to a heterogeneous group of tumours originating from neuroendocrine cells. Primary tumours most commonly occur in the gastrointestinal tract, although they can arise in any part of the human body. Radioligand therapy (RLT) is recommended for progressive or inoperable cases in subsequent lines of the therapy. Our study aimed to investigate glucose metabolism alterations during and after radioligand therapy in patients with neuroendocrine neoplasms undergoing radioligand therapy.

The study was performed on 41 patients with inoperable neuroendocrine tumours, who underwent one cycle (4 courses) of radioligand therapy with [¹⁷⁷Lu]Lu-DOTA-TATE alone or tandem therapy with [¹⁷⁷Lu]Lu-DOTA-TATE and [⁹⁰Y]Y-DOTA-TATE with a standardised nephroprotection protocol. Laboratory parameters were analysed during the first and fourth courses and one year after the last course of treatment.

The study showed a statistically insignificant increase in fasting glucose concentration during and after radioligand therapy, accompanied by a parallel increase in insulin concentration. In patients treated with tandem therapy, the increase in fasting glucose was higher, but the results were still statistically insignificant. No glycaemic severe adverse events [Common Terminology Criteria for Adverse Events (CTCAE) G3-G5] were observed.

Radioligand therapy potentially increases fasting glucose concentrations, probably due to changes in peripheral glucose metabolism. However, it remains a safe treatment method for patients with neuroendocrine neoplasms and does not cause severe glycaemic adverse events related to glucose metabolism.