Evaluation of ¹⁷⁷Lu-Dotatate treatment in patients with metastatic neuroendocrine tumors and prognostic factors

Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE in Advanced Neuroendocrine Tumours (NETs) in a Limited Resource Environment

“…There was no signi cant difference concerning OS compared to several baseline characteristics of patients which may be due to the small sample size and low number of events. Abou Jokh Casas E et al reported that several factors can affect the OS after PRRT with 177Lu-DOTATATE in patients with metastatic NETs including toxicity in previous treatment, tumor grade and presence of bon lesions [7]. In another study, it has been shown that in patients with grade 1 and 2 gastroenteropancreatic NET, PRRT resulted favorable response and long term outcome indicated that tumor grade is the most powerful predictive factor in OS [19].…”

“…In the recent decades, after it has been demonstrated that NETs can be detected with radiolabeled somatostatin analogues such as 68Ga-DOTATATE PET/CT and 99mTc-octreotide, PRRT has been introduced as a therapeutic option for NETs, especially in patients who were refractory or progressive to conventional therapeutic modalities such as surgery, somatostatin analogues therapy and chemotherapy. From time of introducing, several studies have been performed for evaluation of clinical e cacy and safety of PRRT [2,3,7,8,[10][11][12][13]. In a phase 3 trial, e cacy and safety of 177Lu-DOTATATE therapy in advanced and progressive midgut NETs in comparison with somatostatin analogues therapy (control group) had been evaluated which resulted in 18% response rate in PRRT group in comparison with 3% in the control group.…”

“…In concordance to our results, E. Abou Jokh Casas et al reported effectiveness of PRRT in 69% of patients with NETs. However, they reported progression in 25% of patients [7]. Dik J. Kwekkeboom et al evaluated effectiveness of PRRT with 177Lu-octreotide as a radiolabeled somatostatin analogue in patients with metastasized or inoperable endocrine gastroenteropancreatic tumors that resulted in among 131 treated patients, CR in 2%, PR in 26%, minor response in 19%, SD in 35% and PD in 18% of patients [3].…”

“…Leucopenia developed in 6 including grade 2 in 3 and grade 1 in 3 patients, nephrotoxicity of grade 1 in 2 and thrombocytopenia of grade 1 in 2 of patients. In a study, it has been reported that during PRRT, hematological toxicity had been observed in 38.8% of patients [7]. A multicenter study evaluated 450 patients with NETs, it has been revealed that PRRT has rare serious adverse events including leukopenia of grade 3 in 1.1% and thrombocytopenia of grade 3 in 1.3%, and grade 4 thrombocytopenia was observed in only one patient [20].…”

“…Many studies have con rmed promising results of 177Lu-labeled PRRT for treatment of these patients through gamma and beta emission as theranostic agent [2,7,8]. The purpose of this study is to evaluate the clinical e cacy and safety of PRRT with 177Lu-DOTATATE in patients with NETs and impact of this therapy on overall survival and quality of life (QOL).…”