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Survival predictors of 177Lu-Dotatate peptide receptor radionuclide therapy (PRRT) in patients with progressive well-differentiated neuroendocrine tumors (NETS).
Swiha, Mina M; Sutherland, Duncan E K; Sistani, Golmehr; Khatami, Alireza; Abazid, Rami M; Mujoomdar, Amol; Wiseman, Daniele P; Romsa, Jonathan G; Reid, Robert H; Laidley, David T.
Affiliation
  • Swiha MM; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada. mina.swiha@lhsc.on.ca.
  • Sutherland DEK; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
  • Sistani G; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
  • Khatami A; Medical Imaging Department, Division of Diagnostic Radiology, University of Western Ontario, London, ON, Canada.
  • Abazid RM; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
  • Mujoomdar A; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
  • Wiseman DP; Medical Imaging Department, Division of Diagnostic Radiology, University of Western Ontario, London, ON, Canada.
  • Romsa JG; Medical Imaging Department, Division of Diagnostic Radiology, University of Western Ontario, London, ON, Canada.
  • Reid RH; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
  • Laidley DT; Medical Imaging Department, Division of Nuclear Medicine, Victoria Hospital, London Health Sciences Centre, University of Western Ontario, 800 Commissioners Road East, PO Box 5010, London, ON, N6A 5W9, Canada.
J Cancer Res Clin Oncol ; 148(1): 225-236, 2022 Jan.
Article in En | MEDLINE | ID: mdl-34110489
ABSTRACT

PURPOSE:

177Lu-Dotatate is an emerging treatment modality for patients with unresectable or metastatic well-differentiated NETs. This study examines survival predictors in patients who received 177Lu-Dotatate.

METHODS:

A retrospective single-center review was conducted, examining 47 individuals with progressive well-differentiated NETs treated with 177Lu-Dotatate (four induction cycles of 5.5 GBq at 10-week intervals followed by eight maintenance cycles of 3.7 GBq at 6-month intervals).

RESULTS:

Median follow-up was 63.1 months with a median progression-free survival (PFS) of 34.1 months. However, median overall survival (OS) was not reached at the time of analysis. The presence of ≥ 5 bone metastases (hazard ratio HR 4.33; p = 0.015), non-gastroenteropancreatic (non-GEP) NETs (HR 3.22; p = 0.025) and development of interim ascites (HR 3.15; p = 0.047) independently predicted a worse OS. Patients with chromogranin A of ≥ 4 × upper limit of normal (ULN) had shorter OS (p < 0.001) and PFS (p = 0.004). Similarly, those with pre-existing ascites demonstrated a worse OS (p = 0.009) and PFS (p = 0.026). Liver metastases involving greater than 50% liver volume and the existence of unusual metastatic locations had a negative impact on OS (p = 0.033) and PFS (p = 0.026), respectively.

CONCLUSION:

High burden of skeletal and hepatic metastases, non-GEP-NETs, chromogranin A of ≥ 4 × ULN, unusual metastatic sites, pre-existing and interim ascites are predictors of poor outcomes in patients treated with 177Lu-Dotatate. These common indicators can be used for the risk stratification and identification of patients most likely to benefit from PRRT. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02236910, Retrospectively registered on September, 2014.
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Full text: 1 Database: MEDLINE Main subject: Organometallic Compounds / Bone Neoplasms / Octreotide / Neuroendocrine Tumors / Liver Neoplasms Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Year: 2022 Type: Article

Full text: 1 Database: MEDLINE Main subject: Organometallic Compounds / Bone Neoplasms / Octreotide / Neuroendocrine Tumors / Liver Neoplasms Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Year: 2022 Type: Article