Sequencing of Somatostatin-Receptor-Based Therapies in Neuroendocrine Tumor Patients.
J Nucl Med
; 65(3): 340-348, 2024 Mar 01.
Article
em En
| MEDLINE
| ID: mdl-38238038
ABSTRACT
Most well-differentiated neuroendocrine tumors (NETs) express high levels of somatostatin receptors, particularly subtypes 2 and 5. Somatostatin analogs (SSAs) bind to somatostatin receptors and are used for palliation of hormonal syndromes and control of tumor growth. The long-acting SSAs octreotide long-acting release and lanreotide are commonly used in the first-line metastatic setting because of their tolerable side effect profile. Radiolabeled SSAs are used both for imaging and for treatment of NETs. 177Lu-DOTATATE is a ß-emitting radiolabeled SSA that has been proven to significantly improve progression-free survival among patients with progressive midgut NETs and is approved for treatment of metastatic gastroenteropancreatic NETs. A key question in management of patients with gastroenteropancreatic and lung NETs is the sequencing of 177Lu-DOTATATE in relation to other systemic treatments (such as everolimus) or liver-directed therapies. This question is particularly complicated given the heterogeneity of NETs and the near absence of randomized trials comparing active treatment options. This state-of-the-art review examines the evidence supporting use of somatostatin-receptor-targeted treatments within the larger landscape of NET therapy and offers insights regarding optimal patient selection, assessment of benefit versus risk, and treatment sequencing.
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Base de dados:
MEDLINE
Assunto principal:
Segunda Neoplasia Primária
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Tumores Neuroendócrinos
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Carcinoma Neuroendócrino
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article