Prolonged response to 177Lu-DOTATATE therapy of a bone marrow infiltration in a refractory thymic neuro endocrine tumor.

Abstract

Thymic neuro endocrine tumor (tNET) are extremely rare malignancies with poor prognosis, requiring investigation of novel therapeutic approaches. 177Lu-DOTATATE is a successful systemic treatment modality in patients with metastatic gastroenteropancreatic but it role in tNET is not yet well established. Here we report a case of a 39-year-old man with refractory bone marrow infiltration of a tNET, treated by 4 cycles of peptide receptor radionuclide therapy (PRRT) with 177Lu DOTATATE. Since the first cycle, clinical symptoms were substantially decreased, without any severe subacute haematological toxicity. Three months after the end of PRRT, both 68Ga-DOTATOC and 18F-FDG PET confirmed a partial response, already suggested by 177Lu-DOTATATE treatment scan with a significant decrease of the bone marrow uptake between the first and fourth cycle. This report highlights that PRRT could be an effective therapeutic option for advanced bone metastatic disease tNET, with the significant benefit of alleviation of bone pain and radiologic response, without severe or irreversible haematotoxicity.

• Authors: Anne Ségolène Cottereau, Léopoldine Bricaire, Jennifer Arrondeau, Amina Dechmi, Françoise Montravers, Romain Coriat, Jerome Clerc, Lionel Groussin, Florence Tenenbaum
• Journal: Investigational new drugs (Invest New Drugs) Vol. 38 Issue 4 Pg. 1196-1199 (08 2020) ISSN: 1573-0646 [Electronic] United States
• PMID: 31650444 (Publication Type: Case Reports, Journal Article)

Chemical References

• Organometallic Compounds
• Radiopharmaceuticals
• Receptors, Peptide
• lutetium Lu 177 dotatate
• Octreotide

Topics

• Adult
• Bone Marrow Neoplasms (radiotherapy, secondary)
• Humans
• Male
• Neuroendocrine Tumors (diagnostic imaging, pathology, radiotherapy)
• Octreotide (analogs & derivatives, therapeutic use)
• Organometallic Compounds (therapeutic use)
• Positron Emission Tomography Computed Tomography
• Radiopharmaceuticals (therapeutic use)
• Receptors, Peptide
• Thymus Neoplasms (diagnostic imaging, pathology, radiotherapy)
• Treatment Outcome