Real-world efficacy of lutetium peptide receptor radionuclide therapy in patients with neuroendocrine tumours

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Almeamar, HusseinSt Vincents Univ Hosp, ENETS Ctr Excellence, Natl Ctr Neuroendocrine Tumours, Dublin, Ireland. (author)

Real-world efficacy of lutetium peptide receptor radionuclide therapy in patients with neuroendocrine tumours

Article/chapterEnglish2022

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2022-04-29
John Wiley & Sons,2022
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LIBRIS-ID:oai:DiVA.org:uu-485439
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-485439URI
https://doi.org/10.1111/jne.13138DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Lutetium peptide receptor radio nuclide therapy (Lu-PRRT) is an effective treatment for progressive, metastatic, somatostatin-receptor-positive, well-differentiated neuroendocrine tumours (WD-NETs). Here, we report a single centre experience of real-world efficacy, long-term side effects, and challenges of this treatment. This was a retrospective analysis. All patients linked with our centre who had Lu-PRRT were included. Clinicopathological data were analysed using descriptive statistics, Kaplan-Meier, and Cox regression. A total of 45 patients had Lu-PRRT, of those 30 (67%) were males, and 13 (29%) were more than 65 years old. The primary site was small intestine in 30 (67%) patients, pancreas in seven (16%) patients, and lung in three (7%) patients. The tumor was grade 1 in 15 (35%) patients, grade 2 in 22 (48%) patients, and grade 3 in six (13%) patients. A total of 41 (91%) patients had liver metastasis, and 20 (44%) patients had carcinoid syndrome. Lu-PRRT was the second-line therapy in all patients. Krenning's score was 4 in 36 (80%) patients and 3 in nine (20%) patients. The median waiting time to start Lu-PRRT therapy was 87 days. The median follow-up was 41 months. A total of 23 (51%) patients had a partial response, 18 (40%) patients had stable disease, and four (9%) patients had progression. None of the patients had a complete response. The median progression-free survival (PFS) was 38 months (95% CI: 25.8-50.1). The median overall survival (OS) was not reached. Nine patients died during follow-up (death from any cause). Prior treatment with targeted therapies or high dose somatostatin analogues were negative predictors of Lu-PRRT outcome (p-values of < .001 and < .045, respectively). There were two serious haematological toxicities, one patient developed acute myeloid leukaemia (AML), and the other developed chronic myeloid leukaemia (CML). Lu-PRRT is an effective second-line treatment for metastatic WD-NETs. The effect of targeted therapies on Lu-PRRT outcome was significant and needs to be clarified in further studies.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Endokrinologi och diabetes hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Endocrinology and Diabetes hsv//eng
efficacy
neuroendocrine tumours
PRRT
safety

Added entries (persons, corporate bodies, meetings, titles ...)

Cullen, LisaSt Vincents Univ Hosp, ENETS Ctr Excellence, Natl Ctr Neuroendocrine Tumours, Dublin, Ireland. (author)
Murphy, David J.St Vincents Univ Hosp, Dept Radiol, Dublin, Ireland.;UCD Sch Med, Dublin, Ireland. (author)
Crowley, Rachel K.St Vincents Univ Hosp, ENETS Ctr Excellence, Natl Ctr Neuroendocrine Tumours, Dublin, Ireland.;UCD Sch Med, Dublin, Ireland. (author)
Toumpanakis, ChristosRoyal Free Hosp, ENETS Ctr Excellence, London, England. (author)
Welin, StaffanUppsala universitet,Onkologisk endokrinologi(Swepub:uu)stafweli (author)
O'Shea, DonalSt Vincents Univ Hosp, ENETS Ctr Excellence, Natl Ctr Neuroendocrine Tumours, Dublin, Ireland.;UCD Sch Med, Dublin, Ireland. (author)
O'Toole, DermotSt Vincents Univ Hosp, ENETS Ctr Excellence, Natl Ctr Neuroendocrine Tumours, Dublin, Ireland.;Trinity Coll Dublin, Dept Clin Med, Dublin, Ireland. (author)
St Vincents Univ Hosp, ENETS Ctr Excellence, Natl Ctr Neuroendocrine Tumours, Dublin, Ireland.St Vincents Univ Hosp, Dept Radiol, Dublin, Ireland.;UCD Sch Med, Dublin, Ireland. (creator_code:org_t)

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In:Journal of neuroendocrinology: John Wiley & Sons34:60953-81941365-2826

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