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

Liberini, Virginia; Huellner, Martin W.; Grimaldi, Séréna; Finessi, Monica; Thuillier, Philippe; Muni, Alfredo; Pellerito, R.; Papotti, Mauro; Piovesan, Alessandro; Arvat, Emanuela; Deandreis, Désirèe

doi:10.3390/diagnostics10121083

Cited by 32 publications

(18 citation statements)

References 142 publications

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“…Conversely, we might underestimate it as 90 Y-DOTATOC tend to be less used for the EP cohort as it is for the YP cohort reflecting on our attempt to mitigate the anticipated risk for long-term renal toxicity associated with 90 Y-based PRRT regimen [ 18 ]. Due to the difficulties to assess response in NET in general—RECIST criteria are probably not ideal [ 27 ], the clinical benefits were judged—as a proxy—by the treating and referring physicians. It showed consistent and similar high benefits across both cohorts.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Peptide-Receptor Radionuclide Therapy in Elderly Neuroendocrine Tumor Patients

Theiler

Cattaneo

Dierickx

et al. 2021

Cancers

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Peptide receptor radionuclide therapy (PRRT) is a well-established treatment in somatostatin receptor-expressing neuroendocrine tumours (NETs). The safety and efficacy of PRRT in >79 years old patients (EP) have not been systematically investigated. All patients with inoperable/metastatic/progressive G1/G2 NET, >79 years (EP), treated with PRRT at the University Hospital of Basel between 2006 and 2018, were enrolled in this retrospective matched cohort study. Each patient was manually matched with ≥1 younger patient (YP = 60–70 years). The primary endpoint was toxicity. Toxicity (subacute, long-term) was graded according to the criteria for adverse events (CTCAE) v5.0. All toxicity grades ≥ 3, or whose delta (Δ) to baseline were ≥2, were considered significant. The odds ratio (OR) for developing toxicity was tested for non-inferiority of EP vs. YP. Clinical response to PRRT and overall survival (OS) were assessed as secondary outcome measures. Forty-eight EP and 68 YP were enrolled. Both cohorts were balanced regarding median time since diagnosis, tumour location, grading, treatment scheme, and baseline biochemical parameters, except for eGFR (EP: 61 ± 16 vs. YP: 78 ± 19; mL/min/1.73 m2). Twenty-two grade ≥ 3 or Δ ≥ 2 subacute hematotoxicities occurred in 10 EP (10.3% of cycles) and 37 in 19 YP (11.6% of cycles; p = NS). Long-term grade ≥ 3 renal toxicity occurred in 7 EP and 2 YP (p = NS). The median OS was 3.4 years (EP) vs. 6.0 years (YP), HR: 1.50 [0.75, 2.98], p = NS. PRRT is a valid therapeutic option in elderly NET patients with similar toxicity and non-inferior survival compared to matched younger patients.

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Peptide-Receptor Radionuclide Therapy in Elderly Neuroendocrine Tumor Patients

Theiler

Cattaneo

Dierickx

et al. 2021

Cancers

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“…Particularly, SSTR2 overexpressed on the surface of neuroendocrine tumor cells. The high energy of β-particle ( 90 Y or 177 Lu) labeled to a somatostatin receptor (SSTR) ligand caused cell death through direct or indirect DNA damage of target cells (self-dose) or neighboring cells (crossfire effect) [42]. The binding of the radiopharmaceutical to the targeted cells will be indispensable when using Auger emitters.…”

Section: Peptide Receptor Radionuclide Therapy (Prrt)mentioning

confidence: 99%

Radiopharmaceuticals in Modern Cancer Therapy

Elliyanti¹

2022

Radiopharmaceuticals - Current Research for Better Diagnosis and Therapy

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Nuclear medicine plays a role in oncology. It uses tracers (radiopharmaceuticals) to study physiological processes and treat diseases. The radiopharmaceuticals can be formed as radionuclides alone or radionuclides labeled with other molecules as a drug, a protein, or a peptide. The radiopharmaceutical is introduced into the body and accumulates in the target tissue of interest for therapy or imaging purposes. It offers to study cancer biology in vivo to optimize cancer therapy. Another advantage of radiopharmaceutical therapy is a tumor-targeting agent that deposits lethal radiation at tumor sites. This review outlines radiopharmaceuticals agents in current cancer therapy.

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“…Second, the high energy of the radioactive β-particle (yttrium-90 or 177Lu) labeled to a somatostatin receptor (SSTR) ligand yields cell apoptosis through, direct or indirect DNA damage of target cells (self-dose), or via neighboring cells (cross-fire effect). 177Lu is the most used isotope in PRRT ( 10 ).…”

Section: Prrt (Dilemmas and Challenges)mentioning

confidence: 99%

Challenges in Von Hippel–Lindau’s disease: PRRT in patients on hemodialysis

Ayub

Braat

Timmers

et al. 2022

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary Von Hippel–Lindau’s disease (VHL) is a hereditary tumor syndrome characterized by its prototype lesions, hemangioblastomas, and renal cell carcinomas. Treatment for renal cell carcinomas can ultimately result in long-term dialysis. Pancreatic neuroendocrine tumors (pNET) can also occur in the course of the disease. Currently, peptide receptor radionuclide therapy (PRRT) is the standard treatment for progressive neuroendocrine tumors. However, little is known about treatment with PRRT in patients on dialysis, an infrequent presentation in patients with VHL. We present a 72-year-old man with VHL on hemodialysis and a progressive pNET. He received four cycles of PRRT with a reduced dose. Only mild thrombopenia was seen during treatments. The patient died 9 months after the last PRRT because of acute bleeding in a hemangioblastoma. Hemodialysis is not a limiting factor for PRRT treatment and it should be considered as it seems a safe short-term treatment option for this specific group. Learning points Von Hippel–Lindau disease (VHL) is a complex disease in which former interventions can limit optimal treatment for following VHL-related tumors later in life. Metastasized pancreatic neuroendocrine tumors occur as part of VHL disease. Peptide receptor radionuclide therapy seems a safe short-term treatment option in patients on hemodialysis.

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

Cited by 32 publications

References 142 publications

Safety and Efficacy of Peptide-Receptor Radionuclide Therapy in Elderly Neuroendocrine Tumor Patients

Safety and Efficacy of Peptide-Receptor Radionuclide Therapy in Elderly Neuroendocrine Tumor Patients

Radiopharmaceuticals in Modern Cancer Therapy

Challenges in Von Hippel–Lindau’s disease: PRRT in patients on hemodialysis

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