Evaluating the clinical effectiveness of 90Y-SMT 487 in patients with neuroendocrine tumors.
Because of the presence of cell membrane somatostatin receptors (SSTRs), many neuroendocrine tumors will bind analogs of somatostatin. (90)Y-Dodecanetetraacetic acid-Phe1-Tyr3-octreotide (SMT 487) is an SSTR radiopharmaceutical currently under investigation as a therapeutic option for neuroendocrine tumors. Although there are a variety of methods for evaluating response to a given cancer therapy, an important indicator of success is the impact on the clinical status of the patient. The purpose of this work was to develop a semiquantitative method and assess the clinical effectiveness of (90)Y-SMT 487 therapy in patients with neuroendocrine tumors.


METHODS
A scoring system was developed to evaluate clinical response that included the following parameters: weight, health status score (determined by the patient), Karnofsky score, and tumor-related symptoms.


RESULTS
We applied this scoring system to 21 patients who had completed 3 cycles of therapy with (90)Y-SMT 487. Fourteen of the 21 showed a favorable clinical response, whereas 5 were clinically stable after treatment and 2 showed evidence of clinical progression. There was also a significant reduction in the amount of octreotide being used after completion of (90)Y-SMT 487 therapy in the 20 patients who were on this medication.


CONCLUSIONS
Using this scoring method, (90)Y-SMT 487 appears effective in improving the clinical status of patients with (111)In-pentetreotide-positive neuroendocrine tumors.
Bushnell
David
D
Iowa City Veterans Administration Hospital, Diagnostic Imaging and Radioisotope Therapy Service, and Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 55240, USA. david-bushnell@uiowa.edu
O'Dorisio
Thomas
T
Menda
Yusuf
Y
Carlisle
Thomas
T
Zehr
Pamela
P
Connolly
Mary
M
Karwal
Mark
M
Miller
Sara
S
Parker
Stan
S
Bouterfa
Hakim
H
D000328:Adult; D000368:Aged; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D015282:Octreotide / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D011788:Quality of Life; D011859:Radiography; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage*
D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D015282:Octreotide; C106246:Edotreotide