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Front Endocrinol (Lausanne) ; 12: 676973, 2021.
Article in English | MEDLINE | ID: mdl-33935979

ABSTRACT

Peptide receptor radionuclide therapy (PRRT) is an established treatment in advanced neuroendocrine tumors (NETs), which overexpressed somatostatin receptors. However, after progression there are a limited number of available treatments. We want to share a case report about a patient with a NET re-treated with 177Lu-DOTATATE and a literature review about salvage treatment with PRRT. We present a 26-year-old man who started with pelvic pain and after a biopsy of a retro-rectal mass observed in a magnetic resonance was diagnosed with an advanced neuroendocrine tumour. After progression to lanreotide, everolimus and sunitinib, treatment with 177Lu-DOTATATE was initiated, achieving an excellent response with a progression free survival (PFS) of 38 months. At the time of progression, re-treatment with 177Lu-DOTATATE was decided, showing a new partial response, which is currently stable after 15 months. The patient had not presented significant treatment-related toxicity. Although there are no randomized phase III trials or a consensus about the number or dose of cycles, there is evidence about the efficacy and low toxicity of salvage treatment with 177Lu-DOTATATE in NETs. Median progression-free survival ranges from 6 to 22 months. Toxicity is mostly hematologic (anemia and neutropenia), 4-7% grade 3/4.


Subject(s)
Bone Neoplasms/radiotherapy , Neuroendocrine Tumors/radiotherapy , Octreotide/analogs & derivatives , Organometallic Compounds/therapeutic use , Radiopharmaceuticals/therapeutic use , Rectal Neoplasms/radiotherapy , Adult , Antineoplastic Agents/therapeutic use , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/drug therapy , Bone Neoplasms/secondary , Everolimus/therapeutic use , Humans , Magnetic Resonance Imaging , Male , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/drug therapy , Neuroendocrine Tumors/secondary , Octreotide/therapeutic use , Rectal Neoplasms/diagnostic imaging , Rectal Neoplasms/drug therapy , Rectal Neoplasms/pathology , Retreatment , Sunitinib/therapeutic use , Tomography, X-Ray Computed
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