Results and adverse events of personalized peptide receptor radionuclide therapy with 90Yttrium and 177Lutetium in 1048 patients with neuroendocrine neoplasms
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// Richard P. Baum 1 , Harshad R. Kulkarni 1 , Aviral Singh 1 , Daniel Kaemmerer 2 , Dirk Mueller 1 , Vikas Prasad 3 , Merten Hommann 2 , Franz C. Robiller 4 , Karin Niepsch 1 , Holger Franz 5 , Arthur Jochems 6 , Philippe Lambin 6, 7 and Dieter Hörsch 8 1 THERANOSTICS Center for Molecular Radiotherapy, Zentralklinik Bad Berka GmbH, Bad Berka, Germany 2 Department of General and Visceral Surgery, Zentralklinik Bad Berka GmbH, Bad Berka, Germany 3 Clinic for Nuclear Medicine, Charité, Berlin, Germany 4 Center of Molecular Imaging, Zentralklinik Bad Berka GmbH, Bad Berka, Germany 5 Lohmann and Birkner, Berlin, Germany 6 Department of Radiology, GROW - School for Oncology and Developmental Biology, Maastricht University Hospital, Maastricht, The Netherlands 7 Department of Radiation Oncology (The D-Lab), GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands 8 Department of Gastroenterology/Endocrinology, Center for Neuroendocrine Tumors Bad Berka – ENETS Center of Excellence, Zentralklinik Bad Berka GmbH, Bad Berka, Germany Correspondence to: Dieter Hörsch, email: dieter.hoersch@zentralklinik.de Keywords: peptide receptor radionuclide therapy; neuroendocrine tumors; survival; functional syndromes Received: November 11, 2017 Accepted: February 01, 2018 Epub: February 15, 2018 Published: March 30, 2018 ABSTRACT Introduction: Peptide receptor radionuclide therapy (PRRT) of patients with somatostatin receptor expressing neuroendocrine neoplasms has shown promising results in clinical trials and a recently published phase III study. Methods: In our center, 2294 patients were screened between 2004 and 2014 by 68 Ga somatostatin receptor (SSTR) PET/CT. Intention to treat analysis included 1048 patients, who received at least one cycle of 90 Yttrium or 177 Lutetium-based PRRT. Progression free survival was determined by 68 Ga SSTR-PET/CT and EORTC response criteria. Adverse events were determined by CTCAE criteria. Results: Overall survival (95% confidence interval) of all patients was 51 months (47.0-54.9) and differed significantly according to radionuclide, grading, previous therapies, primary site and functionality. Progression free survival (based on PET/CT) of all patients was 19 months (16.9-21), which was significantly influenced by radionuclide, grading, and origin of neuroendocrine neoplasm. Progression free survival after initial progression and first and second resumption of PRRT after therapy-free intervals of more than 6 months were 11 months (9.4-12.5) and 8 months (6.4-9.5), respectively. Myelodysplastic syndrome or leukemia developed in 22 patients (2.1%) and 5 patients required hemodialysis after treatment, other adverse events were rare. Conclusion: PRRT is effective and overall survival is favorable in patients with neuroendocrine neoplasms depending on the radionuclide used for therapy, grading and origin of the neuroendocrine neoplasm which is not exactly mirrored in progression free survival as determined by highly sensitive 68 Ga somatostatin receptor PET/CT using EORTC criteria for determining response to therapy.
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An increasing number of clinical studies suggest that the combination of 90Y and 177Lu could be better than either radionuclide alone for PRRT in NETs, with an improved overall survival.
“An increasing number of clinical studies suggest that the combination of 90Y and 177Lu could be better than either radionuclide alone for PRRT in NETs, with an improved overall survival (55, 56).”
From Alpha-peptide receptor radionuclide therapy using actinium-225 labeled somatostatin receptor agonists and antagonists (2022) · cites this paper as [56]
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- Authors
- Baum, R. P., Kulkarni, H. R., Singh, A., Kaemmerer, D., Mueller, D., Prasad, V., Hommann, M., Robiller, F. C., Niepsch, K., Franz, H., Jochems, A., Lambin, P., & Hörsch, D.
- Affiliations
- Zentralklinik Bad Berka (DE)
- THERANOSTICS Center for Molecular Radiotherapy, Zentralklinik Bad Berka GmbH, Bad Berka, Germany
- Charité – Universitätsmedizin Berlin (DE)
- Lohmann and Birkner, Berlin, Germany
- Maastricht University Medical Centre (NL)
- European Neuroendocrine Tumor Society (DE)
- Corresponding author
- Hörsch, Dieter
- ORCID
- Venue
- Oncotarget
- Publisher
- Impact Journals, LLC
- Published
- 2018-02-15
- Volume
- 9
- Issue
- 24
- Pages
- 16932-16950
- ISSN
- 1949-2553 (ISSN-L)
- PMC
- PMC5908296
- OpenAlex
- W2790526699
- Cited by
- 141
- References
- 38
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 16 · 2023: 11 · 2022: 28 · 2021: 19 · 2020: 30 · 2019: 20 · 2018: 3 · 2017: 1
- FWCI
- 14.05
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Oncotarget (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- peptide receptor radionuclide therapy, neuroendocrine neoplasms, yttrium-90, lutetium-177, somatostatin receptor PET/CT, 68Ga-DOTATATE, treatment response, survival, adverse events, functional syndromes, somatostatin analogues, somatostatin receptor expression
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