Yttrium-90 DOTATOC therapy in GEP-NET and other SST2 expressing tumors: a selected review
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Lutfun Nisa Giordano Savelli Raffaele Giubbini
- چاپ و سال / کشور: 2010
Description
Treatment of somatostatin receptor-positive tumors with radiolabeled somatostatin analog is a promising option. Several phase I and phase II studies done at a few centers around the world reported encouraging results with [90Y-DOTA-Tyr3]-octreotide (DOTATOC) and/or [177Lu-DOTA-Tyr3-Thr8]-octreotate (DOTATATE). The current article is a selective review of patients who were treated mainly with 90Y-DOTATOC after failure with conventional therapy. The aim is to provide an updated comprehensive evaluation of the overall effectiveness of 90Y-DOTATOC therapy in patients with somatostatinpositive tumors. Review of several studies revealed an objective response rate ranging from 20 to 28% for all neuroendocrine tumors (NET)s. For gastroenteropancreatic- NET (GEP-NET), the response rate was found to be consistently better in the range 28–38%. Overall, the cumulative response rate was found to be 24%. An important issue in peptide receptor radionuclide therapy (PRRT) is the dose– response relationship and finding the correct dose of 90Y-DOTATOC that will achieve an optimum tumor kill. Nephrotoxicity was common but could be minimized by taking adequate renal protective measures. In conclusion, PRRT remains a good option in patients with inoperable and/or metastatic NETs particularly of GEP origin. Over a decade of experience with 90Y-DOTATOC proves that it is still an effective tool for the treatment of large infiltrative NETs with achievement of objective radiological responses in nearly a quarter and disease stabilization in more than half the patients studied so far.
Ann Nucl Med (2011) 25:75–85 DOI 10.1007/s12149-010-0444-0 Received: 26 January 2010 / Accepted: 19 October 2010 / Published online: 25 November 2010
