Radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors.

Abstract

PURPOSE:

There are few treatment options for patients with metastasized or inoperable endocrine gastroenteropancreatic (GEP) tumors. Chemotherapy can be effective, but the response is usually less than 1 year. Here, we present the results of treatment with a radiolabeled somatostatin analog, [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate).

PATIENTS AND METHODS:

One hundred thirty-one patients with somatostatin receptor-positive tumors were treated with up to a cumulative dose of 600 to 800 mCi (22.2 to 29.6 GBq) of 177Lu-octreotate.

RESULTS:

One patient developed renal insufficiency, and another patient developed hepatorenal syndrome. Creatinine clearance did not change significantly in the other patients. WHO hematologic toxicity grade 3 or 4 occurred after less than 2% of the administrations. We observed complete remission in three patients (2%), partial remission in 32 patients (26%), minor response (tumor diameter decrease of 25% to 50%) in 24 patients (19%), stable disease (SD) in 44 patients (35%), and progressive disease (PD) in 22 patients (18%). Higher remission rates were positively correlated with high uptake on pretherapy somatostatin receptor imaging and a limited number of liver metastases, whereas PD was significantly more frequent in patients with a low performance score and extensive disease. Median time to progression in 103 patients who either had SD or tumor regression was more than 36 months.

CONCLUSION:

Treatment with 177Lu-octreotate results in tumor remission in a high percentage of patients with GEP tumors. Serious side effects are rare. The median time to progression compares favorably with chemotherapy. Results are better in patients with a limited tumor load. Therefore, early treatment, even in patients who have no PD, may be better.

• Authors: Dik J Kwekkeboom, Jaap J Teunissen, Willem H Bakker, Peter P Kooij, Wouter W de Herder, Richard A Feelders, Casper H van Eijck, Jan-Paul Esser, Boen L Kam, Eric P Krenning
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 23 Issue 12 Pg. 2754-62 (Apr 20 2005) ISSN: 0732-183X [Print] United States
• PMID: 15837990 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Organometallic Compounds
• Receptors, Somatostatin
• lutetium Lu 177 dotatate
• Octreotide

Topics

• Adenoma, Islet Cell (drug therapy, pathology)
• Adult
• Aged
• Aged, 80 and over
• Carcinoid Tumor (drug therapy, pathology)
• Disease Progression
• Endocrine Gland Neoplasms (drug therapy, pathology)
• Female
• Humans
• Liver Neoplasms (drug therapy, secondary)
• Male
• Middle Aged
• Octreotide (analogs & derivatives)
• Organometallic Compounds (adverse effects, pharmacokinetics, therapeutic use)
• Pancreatic Neoplasms (drug therapy, pathology)
• Receptors, Somatostatin
• Treatment Outcome