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177Lu-DOTATATE Ther...
177Lu-DOTATATE Therapy of Advanced Pancreatic Neuroendocrine Tumors Heavily Pretreated With Chemotherapy : Analysis of Outcome, Safety and Their Determinants
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- Fröss-Baron, Katarzyna (author)
- Uppsala universitet,Endokrin tumörbiologi
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- Garske, Ulrike, 1963- (author)
- Uppsala universitet,Radiologi,Department of Nuclear Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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- Welin, Staffan (author)
- Uppsala universitet,Onkologisk endokrinologi
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- Granberg, Dan (author)
- Karolinska Institutet,Uppsala universitet,Onkologisk endokrinologi
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- Eriksson, Barbro (author)
- Uppsala universitet,Endokrin tumörbiologi
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- Khan, Tanweera Shaheena (author)
- Uppsala universitet,Endokrin tumörbiologi
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- Sandström, Mattias (author)
- Uppsala universitet,Radiologi
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- Sundin, Anders, 1954- (author)
- Uppsala universitet,Radiologi
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(creator_code:org_t)
- 2020-02-25
- 2021
- English.
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In: Neuroendocrinology. - : S. Karger. - 0028-3835 .- 1423-0194. ; 111:4, s. 330-343
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Abstract
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- Objective: To retrospectively analyze toxicity, progression-free survival (PFS), overall survival (OS) and their determinants in patients with advanced pancreatic neuroendocrine tumors (panNETs), previously pretreated with chemotherapy, undergoing peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE.Methods: In total, 102 patients with advanced panNETs, previously pretreated with one (67%) or several (33%) lines of chemotherapy were included, of whom 90 % had progressive disease and the majority (74.5%) with grade 2 tumors. 177Lu-DOTATATE, 7.4 GBq per cycle, was administered with 6 to 8 weeks interval, in 88 % of patients utilizing a dosimetry-guided protocol, until an absorbed dose of 23 Gy to the kidneys was reached.Results: Mean 32±10.9 GBq per patient was administered in 1-10 cycles starting median 36 months after panNET diagnosis. Median follow-up was 34 months. Median PFS was 24 months and median OS was 42 months from start of PRRT. Independent risk factors for both progression and death were liver tumor burden >50%, more than one line of previous chemotherapy and elevated alkaline phosphatase (ALP). Resection of the primary tumor was linked to longer survival. Bone marrow toxicity grade 3-4 occurred in 10.8%. One patient (1.0 %) developed acute myeloid leukemia. Bone marrow toxicity was unrelated to type and length of previous chemotherapy, amount of administered activity and absorbed dose to the bone marrow.Conclusion: 177Lu-DOTATATE therapy was feasible, highly effective and safe in patients with advanced panNETs heavily pretreated with chemotherapy. More than one line of chemotherapy was a therapy related independent risk factor for shorter PFS and OS.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Keyword
- Oncology
- Onkologi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Fröss-Baron, Kat ...
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Garske, Ulrike, ...
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Welin, Staffan
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Granberg, Dan
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Eriksson, Barbro
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Khan, Tanweera S ...
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show more...
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Sandström, Matti ...
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Sundin, Anders, ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cancer and Oncol ...
- Articles in the publication
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Neuroendocrinolo ...
- By the university
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Uppsala University
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Karolinska Institutet