Tratamento de Tumores Neuroendócrinos Gastroenteropancreáticos com 177Lu-DOTA-TATE: Experiência do Instituto Português de Oncologia do Porto

Abstract

Introduction: The purpose of this article is to report the experience of Instituto Português de Oncologia do Porto in the treatment of gastroenteropancreatic neuroendocrin tumors with 177Lu-DOTA-TATE, regarding the safety and efficacy of this treatment modality.Material and Methods: A retrospective analysis of clinical reports of patients with gastrentheropancreatic neuroendocrine tumors undergoing treatment with 177Lu-DOTA-TATE between April 2011 and November 2013 was performed.Results: Thirty six cases were reviewed and 30 completed all 3 cycles of 177Lu-DOTA-TATE (83.3%). In these patients it was registered: acute side effects in 8.9% of cycles; grade 3 CTCAE liver toxicity in 13.3% of patients (all with previous abnormal liver function); absence of significant renal or hematologic toxicity; symptomatic improvement in 71.4% of patients; median overall time to progression of 25.6 months; median overall survival from diagnosis of 121.7 months. Patients with higher expression of somatostatin receptors had longer progression-free survival and overall survival times (p < 0.05).Discussion: Peptide receptor radionuclide therapy with 177Lu-DOTA-TATE is an effective, secure and well-tolerated treatment, as evidenced in our study by the following findings: symptomatic improvement in most patients and increased time to disease progression and survival (especially in those with higher sstr expression), with acute and significant subacute/chronic side effects reported only in a minority of cases.Conclusion: Peptide receptor radionuclide therapy with 177Lu-DOTA-TATE is a promising treatment for patients with gastrentheropancreatic neuroendocrin tumors, with demonstrated benefits in terms of safety and efficacy.

<p>Peptide Receptor Radionuclide Therapy for the Treatment of Pancreatic Neuroendocrine Tumors: Recent Insights</p>

“…2 The median disease control rate (DCR) was 83% (range, 50-94%) and the median objective response rate (ORR) was 58% (range, 13-73%). 37,[56][57][58][59][60][61][62][63] The median PFS ranged from 25 to 34 months with a median OS of 42 to 71 months. 30,37,57,60,61,64 A retrospective study of 74 patients with GEP NET showed that panNET patients had a higher ORR (modified SWOG criteria), 73% vs 39% (p=0.005).…”