Individualised ¹⁷⁷Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry

Summary, in English

Purpose: To present data from an interim analysis of a Phase II trial designed to determine the feasibility, safety, and efficacy of individualising treatment based on renal dosimetry, by giving as many cycles as possible within a maximum renal biologically effective dose (BED). Method: Treatment was given with repeated cycles of 7.4 GBq ¹⁷⁷Lu-DOTATATE at 8-12-week intervals. Detailed dosimetry was performed in all patients after each cycle using a hybrid method (SPECT + planar imaging). All patients received treatment up to a renal BED of 27 ± 2 Gy (α/β = 2.6 Gy) (Step 1). Selected patients were offered further treatment up to a renal BED of 40 ± 2 Gy (Step 2). Renal function was followed by estimation and measurement of the glomerular filtration rate (GFR). Results: Fifty-one patients were included in the present analysis. Among the patients who received treatment as planned, the median number of cycles in Step 1 was 5 (range 3-7), and for those who completed Step 2 it was 7 (range 5-8); 73% were able to receive >4 cycles. Although GFR decreased in most patients after the completion of treatment, no grade 3-4 toxicity was observed. Patients with a reduced baseline GFR seemed to have an increased risk of GFR decline. Five patients received treatment in Step 2, none of whom exhibited a significant reduction in renal function. Conclusions: Individualising PRRT using renal dosimetry seems feasible and safe and leads to an increased number of cycles in the majority of patients. The trial will continue as planned.

• Författare: Anna Sundlöv; Katarina Sjögreen-Gleisner; Johanna Svensson; Michael Ljungberg; Tomas G Olsson; Peter Bernhardt; Jan Tennvall
• Avdelning/ar: Tumörmikromiljö; Medicinsk strålningsfysik, Lund; Nuclear Medicine Physics; BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
• Publiceringsår: 2017-03-22
• Språk: Engelska
• Sidor: 1480-1489
• Publikation/Tidskrift/Serie: European Journal of Nuclear Medicine and Molecular Imaging
• Volym: 44
• Issue: 9
• Länkar: http://dx.doi.org/10.1007/s00259-017-3678-4
• Dokumenttyp: Artikel i tidskrift
• Förlag: Springer
• Ämne: Cancer and Oncology; Radiology, Nuclear Medicine and Medical Imaging; Other Physics Topics
• Nyckelord: Lu-DOTATATE; Dosimetry; Neuroendocrine; PRRT; Renal function
• Status: Published
• Forskningsgrupp: Nuclear Medicine Physics
• ISBN/ISSN/Övrigt: ISSN: 1619-7070