학술논문
Efficacy of [177 Lu]Lu-DOTATATE in metastatic neuroendocrine neoplasms of different locations: data from the SEPTRALU study.
Document Type
Article
Author
Mitjavila, Mercedes; Jimenez-Fonseca, Paula; Belló, Pilar; Pubul, Virginia; Percovich, Juan Carlos; Garcia-Burillo, Amparo; Hernando, Jorge; Arbizu, Javier; Rodeño, Emilia; Estorch, Montserrat; Llana, Belén; Castellón, Maribel; García-Cañamaque, Lina; Gajate, Pablo; Riesco, Maria Carmen; Miguel, Maria Begoña; Balaguer-Muñoz, David; Custodio, Ana; Cano, Juana María; Repetto, Alexandra
Source
Subject
*NEUROENDOCRINE tumors
*SOMATOSTATIN receptors
*PEPTIDE receptors
*PROGRESSION-free survival
*SURVIVAL rate
*HOLMIUM
*LUTETIUM compounds
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Language
ISSN
1619-7070
Abstract
Background: Peptide receptor radionuclide therapy (PRRT) is one of the most promising therapeutic strategies in neuroendocrine neoplasms (NENs). Nevertheless, its role in certain tumor sites remains unclear. This study sought to elucidate the efficacy and safety of [177Lu]Lu-DOTATATE in NENs with different locations and evaluate the effect of the tumor origin, bearing in mind other prognostic variables. Advanced NENs overexpressing somatostatin receptors (SSTRs) on functional imaging, of any grade or location, treated at 24 centers were enrolled. The protocol consisted of four cycles of 177Lu-DOTATATE 7.4 GBq iv every 8 weeks (NCT04949282). Results: The sample comprised 522 subjects with pancreatic (35%), midgut (28%), bronchopulmonary (11%), pheochromocytoma/ paraganglioma (PPGL) (6%), other gastroenteropancreatic (GEP) (11%), and other non-gastroenteropancreatic (NGEP) (9%) NENs. The best RECIST 1.1 responses were complete response, 0.7%; partial response, 33.2%; stable disease, 52.1%; and tumor progression, 14%, with activity conditioned by the tumor subtype, but with benefit in all strata. Median progression-free survival (PFS) was 31.3 months (95% CI, 25.7–not reached [NR]) in midgut, 30.6 months (14.4-NR) in PPGL, 24.3 months (18.0-NR) in other GEP, 20.5 months (11.8-NR) in other NGEP, 19.8 months (16.8–28.1) in pancreatic, and 17.6 months (14.4–33.1) in bronchopulmonary NENs. [177Lu]Lu-DOTATATE exhibited scant severe toxicity. Conclusion: This study confirms the efficacy and safety of [177Lu]Lu-DOTATATE in a wide range of SSTR-expressing NENs, regardless of location, with clinical benefit and superimposable survival outcomes between pNENs and other GEP and NGEP tumor subtypes different from midgut NENs. [ABSTRACT FROM AUTHOR]