Τίτλος:
Comparison of 111in-[DTPA]octreotide versus non carrier added 177Lu-[DOTA,Tyr3]-octreotate efficacy in patients with GEP-NET treated intra-arterially for liver metastases
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim: In patients with progressive, metastatic neuroendocrine tumors (NET), intra-arterial radionuclide infusions with high activities of 111In-[DTPA]-octreotide and more recently with non-carrier added (nca) 177Lu-[DOTA, Tyr3]-octreotate have been performed with encouraging results. However, the affinity profiles (IC50) of these radiopeptides for human sst2 receptors are markedly different (111In-[DTPA]-octreotide, 22 ± 3.6 nM and nca 177Lu-[DOTA,Tyr3]-octreotate, 1.5 ± 4.0 nM). The total administered activity is determined by organ dose limits (kidneys and bone marrow), and our aim therefore was to compare and evaluate the therapeutic efficacy of both radiopeptides in metastatic NETs. Methods: Thirty patients with gastroenteropancreatic (GEP) somatostatinpositive NETs with liver metastases confirmed on biopsy and 111In-pentetreotide scan were included. They were treated with 111In-[DTPA]-octreotide (n = 17) or nca 177Lu-[DOTA,Tyr3]-octreotate (n = 13). Blood samples were collected 2, 4, 8, and 24 hours postadministration to calculate residence time in blood and in red marrow. The maximum percentage uptake in organs and tumors was estimated by region of interest analysis, and tumor dosimetry calculations were performed using OLINDA/EXM/1.0 software. Results: nca177Lu-[DOTA,Tyr3]-octreotate blood radioactivity, expressed as a percentage of the injected dose, was significantly lower than 111In-[DTPA]-octreotide (P < 0.05), as clearly depicted from the time-activity curves; the background-corrected tumor uptake was significantly higher than 111In-[DTPA]-octreotide but without any significant difference in other organs (spleen, kidneys, and liver). Conclusions: Using 177Lu-[DOTA,Tyr3]-octreotate, a 3-fold higher absorbed dose to tumor tissue was achieved compared with 111In-[DTPA] octreotide. Residence time of nca 177Lu-[DOTA,Tyr3]-octreotate results in a significantly higher absorbed dose to bone marrow compared with 111In-[DTPA]-octreotide. However, a drawback of 111In-[DTPA]-octreotide therapy is that the number of administrations would need to be almost doubled to achieve an equal therapeutic outcome as compared with 177Lu-[DOTA, Tyr3]-octreotate. © 2015 Wolters Kluwer Health, Inc. All rights reserved.
Συγγραφείς:
Limouris, G.S.
Poulantzas, V.
Trompoukis, N.
Karfis, I.
Chondrogiannis, S.
Triantafyllou, N.
Gennimata, V.
Moulopoulou, L.-E.
Patsouris, E.
Nikou, G.
Michalaki, V.
Fragulidis, G.
Paphiti, M.
McCready, R.V.
Colletti, P.M.
Cook, G.J.
Rubello, D.
Περιοδικό:
Clinical Nuclear Medicine
Εκδότης:
Lippincott Williams and Wilkins
Λέξεις-κλειδιά:
alkaline phosphatase; amino acid; aminotransferase; chromogranin A; dota tate lu 177; dtpa phenylalanine 1 octreotide in 111; novel erythropoiesis stimulating protein; pentetreotide in 111; radioisotope; recombinant erythropoietin; somatostatin receptor; unclassified drug; 111In-octreotide, DTPA(0)-; 177Lu-octreotide, DOTA(0)-Tyr(3)-; octreotide; pentetic acid; radiopharmaceutical agent, abdominal discomfort; adult; aged; anemia; Article; blood sampling; calculation; clinical article; clinical effectiveness; clinical evaluation; comparative study; controlled study; creatinine blood level; diarrhea; dosimetry; drug blood level; drug efficacy; female; follow up; gastroenteropancreatic neuroendocrine tumor; hair loss; headache; hematologic disease; human; human tissue; hypotension; kidney; leukopenia; liver; liver angiography; liver biopsy; liver metastasis; liver toxicity; lung insufficiency; male; mean residence time; myelodysplastic syndrome; nausea; radioactivity; radioisotope distribution; randomized controlled trial (topic); retrospective study; side effect; spleen; systolic blood pressure; thorax pain; thrombocytopenia; treatment response; vomiting; analogs and derivatives; Liver Neoplasms; Neuroendocrine Tumors; pathology; secondary, Adult; Aged; Female; Humans; Liver Neoplasms; Male; Neuroendocrine Tumors; Octreotide; Pentetic Acid; Radiopharmaceuticals
DOI:
10.1097/RLU.0000000000001096
