PRRT in high-grade gastroenteropancreatic neuroendocrine neoplasms (WHO G3)

Sørbye, Halfdan; Kong, Grace; Grozinsky‐Glasberg, Simona

doi:10.1530/erc-19-0400

Cited by 96 publications

(83 citation statements)

References 48 publications

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“…There is recent data in favor of PRRT as second or third-line treatment in GEP-NEN G−3. A review of four studies with more than 10 patients with NEN G−3 treated with PRRT was performed [84]. The majority of patients had a pancreatic tumor and 50% were well differentiated.…”

Section: Peptide Receptor Radionuclide Therapy (Prrt)mentioning

confidence: 99%

Well Differentiated Grade 3 Neuroendocrine Tumors of the Digestive Tract: A Narrative Review

Pellat

Coriat

2020

JCM

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The 2017 World Health Organization (WHO) classification of neuroendocrine neoplasms (NEN) of the digestive tract introduced a new category of tumors named well-differentiated grade 3 neuroendocrine tumors (NET G−3). These lesions show a number of mitosis, or a Ki−67 index higher than 20% with a well-differentiated morphology, therefore separating them from neuroendocrine carcinomas (NEC) which are poorly differentiated. It has become clear that NET G−3 show differences not only in morphology but also in genotype, clinical presentation, and treatment response. The incidence of digestive NET G−3 represents about one third of NEN G−3 with main tumor sites being the pancreas, the stomach and the colon. Treatment for NET G−3 is not yet standardized because of lack of data. In a non-metastatic setting, international guidelines recommend surgical resection, regardless of tumor grading. For metastatic lesion, chemotherapy is the main treatment with similar regimen as NET G−2. Sunitinib has also shown some positive results in a small sample of patients but this needs confirmation. Peptide receptor radionuclide therapy (PRRT) and immunotherapy could be future available treatments after ongoing studies. The goal of this review was to sum up the latest data on the epidemiology and management of digestive NET G−3.

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Section: Peptide Receptor Radionuclide Therapy (Prrt)mentioning

confidence: 99%

Well Differentiated Grade 3 Neuroendocrine Tumors of the Digestive Tract: A Narrative Review

Pellat

Coriat

2020

JCM

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“…NETs in other studies [39,40]. Stratifying the PFS according to the grading, Sorbye et al [41] recently reported a PFS of 19…”

Section: Pathological Tissue Biomarkersmentioning

confidence: 98%

The Challenge of Evaluating Response to Peptide Receptor Radionuclide Therapy in Gastroenteropancreatic Neuroendocrine Tumors: The Present and the Future.

Liberini¹,

Hüllner²,

Grimaldi³

et al. 2020

Preprint

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The NETTER-1 study has proven peptide receptor radionuclide therapy (PRRT) to be one of the most effective therapeutic options for metastatic neuroendocrine tumors (NETs), improving progression-free survival and overall survival. However, PRRT response assessment is challenging and no consensus on methods and timing has yet been reached among experts in the field. This issue is owing to the suboptimal sensitivity and specificity of clinical biomarkers, limitations of morphological response criteria in slowly growing tumors and necrotic changes after therapy, a lack of standardized parameters and timing of functional imaging, and the heterogeneity of PRRT protocols in the literature. The aim of this article is to review the most relevant current approaches for PRRT efficacy prediction and response assessment criteria in order to provide an overview of suitable tools for safe and efficacious PRRT.

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“…Coupled with 68 Ga-imaging ( Figure 10 ), it represents a powerful theranostic tool for the management of neuroendocrine tumors (NETs) [ 175 ]. Current research with [ 177 Lu]-DOTATATE aims to improve the safety and efficacy of this procedure, enlarge possible indication, notably in advanced, poorly-differentiated, GEP-NETs, [ 176 , 177 ] or other NETs, such as pheomochromocytoma or paraganglioma [ 178 , 179 ].…”

Section: Targeting Of Somatostatin Receptors With Radiopharmaceutimentioning

confidence: 99%

Overview of Radiolabeled Somatostatin Analogs for Cancer Imaging and Therapy

et al. 2020

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Identified in 1973, somatostatin (SST) is a cyclic hormone peptide with a short biological half-life. Somatostatin receptors (SSTRs) are widely expressed in the whole body, with five subtypes described. The interaction between SST and its receptors leads to the internalization of the ligand–receptor complex and triggers different cellular signaling pathways. Interestingly, the expression of SSTRs is significantly enhanced in many solid tumors, especially gastro-entero-pancreatic neuroendocrine tumors (GEP-NET). Thus, somatostatin analogs (SSAs) have been developed to improve the stability of the endogenous ligand and so extend its half-life. Radiolabeled analogs have been developed with several radioelements such as indium-111, technetium-99 m, and recently gallium-68, fluorine-18, and copper-64, to visualize the distribution of receptor overexpression in tumors. Internal metabolic radiotherapy is also used as a therapeutic strategy (e.g., using yttrium-90, lutetium-177, and actinium-225). With some radiopharmaceuticals now used in clinical practice, somatostatin analogs developed for imaging and therapy are an example of the concept of personalized medicine with a theranostic approach. Here, we review the development of these analogs, from the well-established and authorized ones to the most recently developed radiotracers, which have better pharmacokinetic properties and demonstrate increased efficacy and safety, as well as the search for new clinical indications.

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PRRT in high-grade gastroenteropancreatic neuroendocrine neoplasms (WHO G3)

Cited by 96 publications

References 48 publications

Well Differentiated Grade 3 Neuroendocrine Tumors of the Digestive Tract: A Narrative Review

Well Differentiated Grade 3 Neuroendocrine Tumors of the Digestive Tract: A Narrative Review

The Challenge of Evaluating Response to Peptide Receptor Radionuclide Therapy in Gastroenteropancreatic Neuroendocrine Tumors: The Present and the Future.

Overview of Radiolabeled Somatostatin Analogs for Cancer Imaging and Therapy

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