Response to treatment with yttrium 90-DOTA-lanreotide of a patient with metastatic gastrinoma.
1,4,7,10-tetraazacyclododecane-N,N',N",N'''-tetraacetic acid (DOTA)-lanreotide is a universal somatostatin (SST) receptor subtype ligand that binds to a large variety of human tumors. We report the case of a patient with metastatic gastrinoma who was treated with 90Y-DOTA-lanreotide. Before treatment, dosimetry with 111In-DOTA-lanreotide (150 MBq, 10 nmol) indicated a dose of 5.8 mGy/MBq for the recurrent abdominal gastrinoma, and a mean dose of approximately 1.0 mGy/MBq for liver metastases (i.e., 56 and approximately 10 mGy/MBq for 90Y-DOTA-lanreotide, respectively). After four infusions of 90Y-DOTA-lanreotide (each 1 GBq, approximately 30 nmol) over a 6-mo period, the 111In-DOTA-lanreotide scintigraphy of the liver had returned to a nearly normal condition and a remarkably decreased uptake by the recurrent gastrinoma was calculated (approximately 5 mGy/MBq for 90Y-DOTA-lanreotide). The imaging results were well-correlated with a 25% regression of the liver metastases as indicated by CT. Blood, urine and whole-body clearances of 111In-DOTA-lanreotide and 90Y-DOTA-lanreotide were very similar. The DOTA-lanreotide promises to be useful for functional tumor diagnosis (111In-DOTA-lanreotide) and receptor-mediated tumor radiotherapy (90Y-DOTA-lanreotide).
Leimer
M
M
Department of Nuclear Medicine, University of Vienna, Austria.
Kurtaran
A
A
Smith-Jones
P
P
Raderer
M
M
Havlik
E
E
Angelberger
P
P
Vorbeck
F
F
Niederle
B
B
Herold
C
C
Virgolini
I
I
D015408:Gastrinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary*; D006571:Heterocyclic Compounds / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary*; D008197:Lymph Node Excision; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D010456:Peptides, Cyclic / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics / Q000627:therapeutic use*; D017481:Receptors, Somatostatin / Q000819:agonists; D012008:Recurrence; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D006571:Heterocyclic Compounds; D010456:Peptides, Cyclic; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; C116409:indium 111-DOTA-lanreotide; C116408:yttrium 90-DOTA-lanreotide