Improved Control of Severe Hypoglycemia in Patients with Malignant Insulinomas by Peptide Receptor Radionuclide Therapy

Abstract

Radiolabeled somatostatin analog therapy can stabilize tumor growth and can be very successful in further controlling severe hypoglycemia in malignant insulinomas. In our series, this eventually resulted in improved survival outside the hospital setting.

Nowotwory neuroendokrynne trzustki — zasady diagnostyki i leczenia (rekomendowane przez Polską Sieć Guzów Neuroendokrynych)

“…Based on individual reports in the literature, it is known that gastrinomas respond to therapy faster, but early progression is relatively frequent [6]. PRRT treatment may improve the control of hypoglycaemia in patients with malignant insulin-secreting tumours [74,148,248,249].…”

A New Theranostic Paradigm for Advanced Thyroid Cancer

“…Notwithstanding the limitations inherent in a retrospective study, including inconsistent RAI imaging methodology and timing, these findings are intriguing because poorly differentiated gastero-entero-pancreatic neuroendocrine tumors typically lose SSTR expression (14). The exception to this rule is insulinoma, in which a significant proportion of benign insulinoma (approximately one third) lack SSTR (15), whereas it is maintained in most malignant lesions, making it a suitable target for peptide receptor radionuclide therapy (PRRT) (16,17). Unlike in most gastero-entero-pancreatic neuroendocrine tumors, a prior immunohistochemical study in thyroid malignancy demonstrated predominant expression of SSTR-5 rather than SSTR-2 (18), favoring radioligands with affinity for SSTR-5 (e.g., 68 Ga-DOTA-NOC or 68 Ga-DOTATOC) over SSTR-2 ligands (e.g., 68 Ga-DOTA-TATE) in this disease.…”

GEP-NETs update: Functional localisation and scintigraphy in neuroendocrine tumours of the gastrointestinal tract and pancreas (GEP-NETs)

“…However, as opposed to benign insulinomas, malignant insulinomas often lack GLP1R (60). Conversely, malignant insulinomas often do express sst 2 , which can be targeted using SRS (24,60,61,62,63,64,65,66). In various studies, GLP1R scintigraphy using 111 In-DOTAexendin-4 successfully detected benign insulinomas (60,67,68,69,70).…”