Radiolabeled Somatostatin Analog [177Lu-DOTA0,Tyr3]Octreotate in Patients With Endocrine Gastroenteropancreatic Tumors
Open accessAbstract
Purpose: There are few treatment options for patients with metastasized or inoperable endocrine gastroenteropancreatic (GEP) tumors. Chemotherapy can be effective, but the response is usually less than 1 year. Here, we present the results of treatment with a radiolabeled somatostatin analog, [177 Lu-DOTA 0,Tyr 3]octreotate (177 Lu-octreotate). Patients and Methods: One hundred thirty-one patients with somatostatin receptor-positive tumors were treated with up to a cumulative dose of 600 to 800 mCi (22.2 to 29.6 GBq) of 177 Lu-octreotate. Results: One patient developed renal insufficiency, and another patient developed hepatorenal syndrome. Creatinine clearance did not change significantly in the other patients. WHO hematologic toxicity grade 3 or 4 occurred after less than 2% of the administrations. We observed complete remission in three patients (2%), partial remission in 32 patients (26%), minor response (tumor diameter decrease of 25% to 50%) in 24 patients (19%), stable disease (SD) in 44 patients (35%), and progressive disease (PD) in 22 patients (18%). Higher remission rates were positively correlated with high uptake on pretherapy somatostatin receptor imaging and a limited number of liver metastases, whereas PD was significantly more frequent in patients with a low performance score and extensive disease. Median time to progression in 103 patients who either had SD or tumor regression was more than 36 months. Conclusion: Treatment with 177 Lu-octreotate results in tumor remission in a high percentage of patients with GEP tumors. Serious side effects are rare. The median time to progression compares favorably with chemotherapy. Results are better in patients with a limited tumor load. Therefore, early treatment, even in patients who have no PD, may be better.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
With adoption of amino acid pretreatment, the incidence of serious toxicity has been low, at or below 1.5% grade III or IV CTCAE, regardless of treatment schedule, number of cycles, and administered activity per cycle or cumulatively.
“In fact, with the adoption of amino acid pretreatment, the incidence of serious toxicity has been low, # 1.5% grade III or IV CTCAE, regardless of the treatment schedule, the number of cycles and administered activity per cycle or cumulatively ( 65 , 66 ).”
From Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns (2021) · cites this paper as [66]
The Methods describe amino-acid infusion before treatment, and the Results report low rates of severe hematologic toxicity. However, the paper uses WHO rather than CTCAE grades; grade 3 and 4 thrombocytopenia occurred after 1.5% and 0.2% of administrations, respectively, exceeding 1.5% when combined. It does not establish that toxicity was low regardless of schedule, cycle count, or administered activity. Page numbers were not provided in our copy. (LLM, conf=0.89)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Reubi, J. C., Schär, J.-C., Waser, B., Wenger, S., Heppeler, A., Schmitt, J. S., & Mäcke, H. R. (2000) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s002590050034 · Cited by 1,127 · see citing works
Moertel, C. G., Lefkopoulo, M., Lipsitz, S. R., Hahn, R. G., & Klaassen, D. J. (1992) · New England Journal of Medicine · doi:10.1056/nejm199202203260804 · Cited by 968 · see citing works
Moertel, C. G., Hanley, J. A., & Johnson, L. A. (1980) · New England Journal of Medicine · doi:10.1056/nejm198011203032101 · Cited by 659 · see citing works
Southwest Oncology Group standard response criteria, endpoint definitions and toxicity criteria
Green, S., & Weiss, G. R. (1992) · Investigational New Drugs · doi:10.1007/bf00944177 · Cited by 618 · see citing works
Faiss, S., Pape, U., Böhmig, M., Dörffel, Y., Mansmann, U., Golder, W. A., Riecken, E. O., & Wiedenmann, B. J. (2003) · Journal of Clinical Oncology · doi:10.1200/jco.2003.12.142 · Cited by 499 · see citing works
[177Lu-DOTA0,Tyr3]octreotate: comparison with [111In-DTPA0]octreotide in patients
Kwekkeboom, D. J., Bakker, W. H., Kooij, P. P. M., Konijnenberg, M., Srinivasan, A., Erion, J. L., Schmidt, M. A., Bugaj, J. E., de Jong, M., & Krenning, E. P. (2001) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s002590100574 · Cited by 469 · see citing works
Self-citationTumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq (90)Y-DOTATOC.
Waldherr, C., Pless, M., Maëcke, H. R., et al. (2002) · PubMed · Cited by 446 · see citing works
Valkema, R., de Jong, M., Bakker, W. H., Breeman, W. A. P., Kooij, P. P. M., Lugtenburg, P. J., de Jong, F. H., Christiansen, A., Kam, B. L. R., de Herder, W. W., et al. (2002) · Seminars in Nuclear Medicine · doi:10.1053/snuc/2002.31025 · Cited by 432 · see citing works
Self-citationKwekkeboom, D. J., Bakker, W. H., Kam, B. L. R., Teunissen, J. J. M., Kooij, P. P. M., de Herder, W. W., Feelders, R. A., van Eijck, C. H. J., de Jong, M., Srinivasan, A., et al. (2003) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-002-1050-8 · Cited by 426 · see citing works
Self-citationYttrium-90 DOTATOC: first clinical results
Otte, A., Herrmann, R. P., Heppeler, A., Béhé, M. P., Jermann, E., Powell, P., Maëcke, H. R., & Muller, J. (1999) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s002590050476 · Cited by 421 · see citing works
Waldherr, C., Pless, M., Maëcke, H. R., Haldemann, A. R., & Mueller‐Brand, J. (2001) · Annals of Oncology · doi:10.1023/a:1011160913619 · Cited by 396 · see citing works
Bodei, L., Cremonesi, M., Zoboli, S., Grana, C. M., Bartolomei, M., Rocca, P. A., Caracciolo, M., Mäcke, H. R., Chinol, M., & Paganelli, G. (2003) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-002-1023-y · Cited by 304 · see citing works
Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies
Anthony, L. B., Woltering, E. A., Espenan, G. D., Cronin, M. D., Maloney, T. J., & McCarthy, K. E. (2002) · Seminars in Nuclear Medicine · doi:10.1053/snuc.2002.31769 · Cited by 277 · see citing works
Pelosi, G., Bresaola, E., Bogina, G. S., et al. (1996) · Human Pathology · doi:10.1016/s0046-8177(96)90303-2 · Cited by 268 · see citing works
Prognostic criteria in nonfunctioning pancreatic endocrine tumours
Rosa, S. L., Capella, C., Sessa, F., et al. (1996) · Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin · doi:10.1007/bf00198436 · Cited by 247 · see citing works
Treatment of the carcinoid tumor and the malignant carcinoid syndrome.
Moertel, C. G. (1983) · Journal of Clinical Oncology · doi:10.1200/jco.1983.1.11.727 · Cited by 246 · see citing works
Janson, E. T., & Öberg, K. (1993) · Acta Oncologica · doi:10.3109/02841869309083916 · Cited by 205 · see citing works
The antitumoral effect of the long-acting somatostatin analog lanreotide in neuroendocrine tumors
Ducreux, M. P., Ruszniewski, P. B., Chayvialle, J. A., et al. (2000) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2000.03210.x · Cited by 193 · see citing works
Possible carcinogenic effect of 6-mercaptopurine on bone marrow stem cells
Thomsen, J. B., Schr�der, H., Kristinsson, J., Madsen, B., Szumlanski, C. L., Weinshilboum, R. M., Andersen, J. B., & Schmiegelow, K. (1999) · Cancer · doi:10.1002/(sici)1097-0142(19990915)86:6 · Cited by 170 · see citing works
Testicular function after radioiodine therapy for thyroid carcinoma
Wichers, M., Benz, E., Palmedo, H., Biersack, H. J., Grünwald, F., & Klingmüller, D. (2000) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s002590050535 · Cited by 122 · see citing works
90Y–DOTA– D ‐Phe1–Try3– octreotide in therapy of neuroendocrine malignancies
Paganelli, G., Bodei, L., Handkiewicz-Junak, D., et al. (2002) · Biopolymers · doi:10.1002/bip.10349 · Cited by 106 · see citing works
Chemotherapy for Gastro-Enteropancreatic Endocrine Tumours
O’Toole, D., Hentic, O., Corcos, O., et al. (2004) · Neuroendocrinology · doi:10.1159/000080747 · Cited by 83 · see citing works
Gastroenteropancreatic Endocrine Tumours: Effect of Sandostatin® on Tumour Growth
Arnold, R., Benning, R., Neuhaus, C., et al. (2009) · Digestion · doi:10.1159/000201081 · Cited by 65 · see citing works
Treatment of metastatic carcinoid tumor with dactinomycin or dacarbazine.
Ga, V. H., Rubin, J., & Cg, M. (1983) · PubMed · Cited by 51 · see citing works
Tokita, N., Hasegawa, S., Maruyama, K., Izumi, T., Blankenberg, F., Tait, J., Strauss, W., & Nishimura, T. (2003) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-002-1006-z · Cited by 49 · see citing works
Andreyev, J. N., Scott-Mackie, P., Cunningham, D., et al. (1995) · Journal of Clinical Oncology · doi:10.1200/jco.1995.13.6.1486 · Cited by 46 · see citing works
Prestigiacomo, C. J., Balmaceda, C. M., & Dalmau, J. O. (2001) · Cancer · doi:10.1002/1097-0142(20010415)91:8 · Cited by 44 · see citing works
Treatment of metastasized midgut carcinoids with dacarbazine.
Ritzel, U., Leonhardt, U., Stöckmann, F., et al. (1995) · PubMed · Cited by 43 · see citing works
Growth hormone, insulin, and somatostatin therapy of cancer cachexia
Bartlett, D. L., Torosian, M. H., & Charland, S. L. (1994) · Cancer · doi:10.1002/1097-0142(19940301)73:5 · Cited by 40 · see citing works
Kidney failure after treatment with 90Y-DOTATOC
Schumacher, T., Waldherr, C., Mueller‐Brand, J., et al. (2001) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-001-0720-2 · Cited by 24 · see citing works
Gurevich, L. E., Казанцева, И. А., Va, I., et al. (2003) · Cancer · doi:10.1002/cncr.11739 · Cited by 22 · see citing works
Neijt, J. P., Lacave, A. J., Splinter, T. A. W., et al. (1995) · British Journal of Cancer · doi:10.1038/bjc.1995.21 · Cited by 22 · see citing works
Low Nuclear Proliferative Activity Is Associated With Nonmetastatic Islet Cell Tumors
Jordà, M., Ghorab, Z., Fernández, G. L., et al. (2003) · Archives of Pathology & Laboratory Medicine · doi:10.5858/2003-127-196-lnpaia · Cited by 17 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Bodei, L., Kidd, M., Paganelli, G., Grana, C. M., Drozdov, I., Cremonesi, M., Lepensky, C., Kwekkeboom, D. J., Baum, R. P., Krenning, E. P., et al. (2015) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-014-2893-5 · Cited by 465 · see citing works
Self-citationBodei, L., Cremonesi, M., Ferrari, M., Pacifici, M., Grana, C. M., Bartolomei, M., Baio, S. M., Sansovini, M., & Paganelli, G. (2008) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-008-0778-1 · Cited by 428 · see citing works
ENETS Consensus Guidelines for the management of patients with gastroduodenal neoplasms
Delle Fave, G., Kwekkeboom, D. J., Van Cutsem, E., Rindi, G., Kos-Kudla, B., Knigge, U., Sasano, H., Tomassetti, P., Salazar, R., & Ruszniewski, P. (2012) · Neuroendocrinology · doi:10.1159/000335595 · Cited by 327 · see citing works
Self-citationGarske-Román, U., Sandström, M., Fröss Baron, K., Lundin, L., Hellman, P., Welin, S., Johansson, S., Khan, T., Lundqvist, H., Eriksson, B., et al. (2018) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-018-3945-z · Cited by 254 · see citing works
Okamoto, S., Thieme, A., Allmann, J., D’Alessandria, C., Maurer, T., Retz, M., Tauber, R., Heck, M. M., Wester, H.-J., Tamaki, N., et al. (2017) · Journal of Nuclear Medicine · doi:10.2967/jnumed.116.178483 · Cited by 213 · see citing works
Chromogranin A—unspecific neuroendocrine marker. Clinical utility and potential diagnostic pitfalls
Gut, P., Czarnywojtek, A., Fischbach, J., Bączyk, M., Ziemnicka, K., Wrotkowska, E., Gryczyńska, M., & Ruchała, M. (2016) · Archives of Medical Science · doi:10.5114/aoms.2016.57577 · Cited by 144 · see citing works
Cremonesi, M., Ferrari, M. E., Bodei, L., Chiesa, C., Sarnelli, A., Garibaldi, C., Pacilio, M., Strigari, L., Summers, P. E., Orecchia, R., et al. (2018) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-018-4044-x · Cited by 141 · see citing works
Normal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns
Wahl, R. L., Sgouros, G., Iravani, A., Jacene, H., Pryma, D., Saboury, B., Capala, J., & Graves, S. A. (2021) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.262751 · Cited by 95 · see citing works
Nikou, G. C., Marinou, K., Thomakos, P., Papageorgiou, D., Sanzanidis, V., Nikolaou, P., Kosmidis, C., Moulakakis, A., & Mallas, E. (2008) · Pancreatology · doi:10.1159/000152000 · Cited by 84 · see citing works
Carcinoid syndrome: diagnosis and medical management
van der Lely, A. J., & Herder, W. W. D. (2005) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302005000500028 · Cited by 73 · see citing works
Self-citationIravani, A., Violet, J., Azad, A., & Hofman, M. S. (2020) · Prostate Cancer and Prostatic Diseases · doi:10.1038/s41391-019-0174-x · Cited by 68 · see citing works
Klomp, M. J., Dalm, S. U., de Jong, M., Feelders, R. A., Hofland, J., & Hofland, L. J. (2021) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-020-09607-z · Cited by 69 · see citing works
- Authors
- Kwekkeboom, D. J., Teunissen, J. J., Bakker, W. H., Kooij, P. P., de Herder, W. W., Feelders, R. A., van Eijck, C. H., Esser, J.-P., Kam, B. L., & Krenning, E. P.
- Affiliations
- Erasmus MC (NL)
- From the Departments of Nuclear Medicine, Internal Medicine, and Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
- Venue
- Journal of Clinical Oncology
- Published
- 2005-04-20
- Volume
- 23
- Issue
- 12
- Pages
- 2754-2762
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2108613323
- Cited by
- 657
- References
- 33
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 21 · 2023: 20 · 2022: 29 · 2021: 27 · 2020: 21 · 2019: 28 · 2018: 30 · 2017: 29 · 2016: 29 · 2015: 30 · 2014: 27 · 2013: 50 · 2012: 31
- FWCI
- 38.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- Erasmus Medisch Centrum
- Topics
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Oncology › Peptidase Inhibition and Analysis
- Keywords
- lutetium-177, somatostatin analogues, neuroendocrine tumors, somatostatin receptor imaging, tumor response, time to progression, hepatorenal syndrome, renal failure, hematologic toxicity, liver metastasis, performance status
- MeSH terms
- Adult, Aged, Aged, 80 and over, Carcinoid Tumor, Endocrine Gland Neoplasms, Female, Humans, Adenoma, Islet Cell, Liver Neoplasms, Male, Middle Aged, Organometallic Compounds, Pancreatic Neoplasms, Octreotide, Treatment Outcome, Receptors, Somatostatin, Disease Progression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
