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

Författare:
  • Anna Sundlöv
  • Katarina Sjögreen-Gleisner
  • Johanna Svensson
  • Michael Ljungberg
  • Tomas G Olsson
  • Peter Bernhardt
  • Jan Tennvall
Publiceringsår: 2017-03-22
Språk: Engelska
Sidor: 1480-1489
Publikation/Tidskrift/Serie: European Journal of Nuclear Medicine and Molecular Imaging
Volym: 44
Nummer: 9
Dokumenttyp: Artikel i tidskrift
Förlag: Springer

Abstract 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.

Keywords

  • Cancer and Oncology
  • Radiology, Nuclear Medicine and Medical Imaging
  • Lu-DOTATATE
  • Dosimetry
  • Neuroendocrine
  • PRRT
  • Renal function

Other

Published
  • Nuclear Medicine Physics
  • ISSN: 1619-7070
Michael Ljungberg
E-post: michael [dot] ljungberg [at] med [dot] lu [dot] se

Professor

Medicinsk strålningsfysik, Lund

+46 46 17 35 65

+46 70 817 31 15

SUS Lund Kampradhuset 12-11

Barngatan 2:1, Lund

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Avdelningschef

Medicinsk strålningsfysik, Lund

32

Avdelningsföreståndare

Medicinsk strålningsfysik, Lund

32

Projektledare

Nuclear Medicine Physics

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