Indium-111–Pentetreotide Scintigraphy and Somatostatin Receptor Subtype 2 Expression: New Prognostic Factors for Malignant Well-Differentiated Endocrine Tumors

Asnacios, Amani; Courbon, F.; Rochaix, Philippe; Bauvin, Éric; Cances-Lauwers, Valérie; Susini, Christiane; Schulz, Stefan; Boneu, A; Guimbaud, Rosine; Buscail, Louis

doi:10.1200/jco.2007.12.7431

Cited by 97 publications

(84 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Preliminary results in single patients suggest that this new radiopeptide locates more metastases than do sst 2 -specific tracers (7,8). This finding is supported by Asnacios et al, who found sst 3 and sst 5 expression in 111 In-DTPA-octreotidenegative tumors (9).…”

supporting

confidence: 76%

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

et al. 2013

View full text Add to dashboard Cite

Somatostatin receptor PET tracers such as [ 68 Ga-DOTA, 1-Nal 3 ]-octreotide ( 68 Ga-DOTANOC) and [ 68 Ga-DOTA,Tyr 3 ]-octreotate ( 68 Ga-DOTATATE) have shown promising results in patients with neuroendocrine tumors, with a higher lesion detection rate than is achieved with 18 F-fluorodihydroxyphenyl-Lalanine PET, somatostatin receptor SPECT, CT, or MR imaging. 68 Ga-DOTANOC has high affinity for somatostatin receptor subtypes 2, 3, and 5 (sst 2,3,5 ). It has a wider receptor binding profile than 68 Ga-DOTATATE, which is sst 2 -selective. The wider receptor binding profile might be advantageous for imaging because neuroendocrine tumors express different subtypes of somatostatin receptors. The goal of this study was to prospectively compare 68 Ga-DOTANOC and 68 Ga-DOTATATE PET/CT in the same patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and to evaluate the clinical impact of 68 Ga-DOTANOC PET/CT. Methods: Eighteen patients with biopsy-proven GEP-NETs were evaluated with 68 Ga-DOTANOC and 68 Ga-DOTATATE using a randomized crossover design. Labeling of DOTANOC and DOTATATE with 68 Ga was standardized using a fully automated synthesis device. PET/CT findings were compared with 3-phase CT scans and in some patients with MR imaging, 18 F-FDG PET/CT, and histology. Uptake in organs and tumor lesions was quantified and compared by calculation of maximum standardized uptake values (SUVmax) using volume computer-assisted reading. Results: Histology revealed low-grade GEP-NETs (G1) in 4 patients, intermediate grade (G2) in 7, and high grade (G3) in 7. 68 Ga-DOTANOC and 68 Ga-DOTATATE were false-negative in only 1 of 18 patients. In total, 248 lesions were confirmed by crosssectional and PET imaging. The lesion-based sensitivity of 68 Ga-DOTANOC PET was 93.5%, compared with 85.5% for 68 Ga-DOTATATE PET (P 5 0.005). The better performance of 68 Ga-DOTANOC PET is attributed mainly to the significantly higher detection rate of liver metastases rather than tumor differentiation grade. Multivariate analysis revealed significantly higher SUVmax in G1 tumors than in G3 tumors (P 5 0.009).This finding was less pronounced with 68 Ga-DOTANOC (P . 0.001). Altogether, 68 Ga-DOTANOC changed treatment in 3 of 18 patients (17%). Conclusion: The sst 2,3,5 -specific radiotracer 68 Ga-DOTANOC detected significantly more lesions than the sst 2 -specific radiotracer 68 Ga-DOTATATE in our patients with GEP-NETs. The clinical relevance of this finding has to be proven in larger studies.

show abstract

supporting

confidence: 76%

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Median OS was only 15 mo (95% confidence interval, 4-27) for 18 F-FDG-avid NETs versus 119.5 mo (95% confidence interval, 72-N) for 18 F-FDG-negative NETs (P , 10 23 ). This difference was still significant for patients with positive somatostatin receptor scintigraphy (SRS) results, usually considered a good prognostic indicator (2,3).…”

Section: Replymentioning

confidence: 97%

Reply: Modifying the Poor Prognosis Associated with ¹⁸F-FDG–Avid NET with Peptide Receptor Chemo-Radionuclide Therapy (PRCRT)

Garin¹,

Edeline²

2015

J Nucl Med

View full text Add to dashboard Cite

“…internalization and desensitization with respect to the number of SSTRs at the cell surface, causing modification of the ratio expression between different cell surface receptors, altering the downstream signaling triggered by the receptor, causing up-or downregulation of the pre-existing intracellular pathways, and even creating new intracellular signaling pathways by the formation of homo-and heterodimers between different receptor subtypes or other receptor superfamily [33][34][35][44][45][46][47][48][49][50].…”

Section: Resistance To Somatostatin Analogsmentioning

confidence: 99%

Inhibition of Peripheral Synthesis of Serotonin as a New Target in Neuroendocrine Tumors

et al. 2016

View full text Add to dashboard Cite

The carcinoid syndrome represents a set of signs and symptoms associated with neuroendocrine tumors (NETs) that occur primarily when metastases are developed in the liver, resulting in the worsening of quality of life. Serotonin plays a central role in the physiology of carcinoid syndrome by promoting intestinal motility. Somatostatin analogs (SSAs) have widely demonstrated their efficacy as symptomatic relievers of carcinoid syndrome, but this control is ephemeral, being reduced by approximately 50% within the first year. The exact mechanisms of resistance to SSAs are not fully understood, but it is believed that serotonin might be involved. Patients with carcinoid syndrome present with a significant increase in serotonin plasma levels and, consequently, in the soluble urinary metabolite 5‐hydroxyindole acetic acid. Telotristat etiprate is a potent inhibitor of tryptophan hydroxylase, a rate‐limiting enzyme in the synthesis of serotonin, that has demonstrated in the phase III TELESTAR clinical trial a significant improvement in the control of bowel movements in patients with NETs who have carcinoid syndrome and who have progressed to an SSA. Based on these results, telotristat etiprate has emerged as a potential new option in the treatment algorithm of symptomatic control of functioning NETs. However, some issues need to be clarified, such as the safety profile of the drug outside clinical trials, the benefit in quality of life, and the possible impact on tumor growth, as well as its role within sequencing or combination treatment strategies with pre‐existing drugs effective in NET treatment. Implications for Practice: This article reviews the literature about carcinoid syndrome, which affects patients diagnosed with neuroendocrine tumors. Few articles have been published about this syndrome and its pathophysiology. Somatostatin analogs provide symptomatic relief; however, patients may become refractory to this strategy, usually within the first year of treatment. In this context, as an agent with an innovative mechanism of action, telotristat etiprate has demonstrated activity in a phase III trial, and findings may offer a path to an improve quality of life and prolonged survival for certain patients.

show abstract

Indium-111–Pentetreotide Scintigraphy and Somatostatin Receptor Subtype 2 Expression: New Prognostic Factors for Malignant Well-Differentiated Endocrine Tumors

Abstract: We demonstrate the prognostic value of (111)In-pentetreotide scintigraphy in well-differentiated malignant endocrine tumors. In these tumors, sst2 somatostatin receptor expression correlates with both tracer uptake and a better prognosis.

Cited by 97 publications

References 31 publications

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Reply: Modifying the Poor Prognosis Associated with ¹⁸F-FDG–Avid NET with Peptide Receptor Chemo-Radionuclide Therapy (PRCRT)

Inhibition of Peripheral Synthesis of Serotonin as a New Target in Neuroendocrine Tumors

Contact Info

Product

Resources

About

Indium-111–Pentetreotide Scintigraphy and Somatostatin Receptor Subtype 2 Expression: New Prognostic Factors for Malignant Well-Differentiated Endocrine Tumors

Abstract: We demonstrate the prognostic value of (111)In-pentetreotide scintigraphy in well-differentiated malignant endocrine tumors. In these tumors, sst2 somatostatin receptor expression correlates with both tracer uptake and a better prognosis.

Cited by 97 publications

References 31 publications

Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Reply: Modifying the Poor Prognosis Associated with 18F-FDG–Avid NET with Peptide Receptor Chemo-Radionuclide Therapy (PRCRT)

Inhibition of Peripheral Synthesis of Serotonin as a New Target in Neuroendocrine Tumors

Contact Info

Product

Resources

About

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Comparison of ⁶⁸Ga-DOTANOC and ⁶⁸Ga-DOTATATE PET/CT Within Patients with Gastroenteropancreatic Neuroendocrine Tumors

Reply: Modifying the Poor Prognosis Associated with ¹⁸F-FDG–Avid NET with Peptide Receptor Chemo-Radionuclide Therapy (PRCRT)