Endocrine tumours of the gastrointestinal tract. Peptide receptor radionuclide therapy.
Peptide receptor radionuclide therapy is a new treatment modality for patients with inoperable or metastasised neuroendocrine gastroenteropancreatic tumours. After the successful implementation of somatostatin receptor scintigraphy in daily clinical practice, the next logical step was to increase the radiation dose of the administered radiolabelled somatostatin analogue in an attempt to induce tumour shrinkage. Since then, an increasing number of patients has been successfully treated with this approach, resulting in a substantial numbers of patient with objective tumour shrinkage. Serious side-effects have been rare. This article reviews the effectiveness of the different radiolabelled somatostatin analogues used, the currently known side-effects and the survival data available. Furthermore, clinical issues, including indication and timing of therapy, are discussed. Finally, important directions for future research are briefly mentioned to illustrate that, although the currently available results already suggest a favourable outcome compared with other systemic therapies, new strategies are being developed to increase efficacy.
Teunissen
Jaap J M
JJ
Department of Nuclear Medicine, Erasmus MC, Rotterdam GD, The Netherlands. j.teunissen@erasmusmc.nl
Kwekkeboom
Dik J
DJ
de Jong
Marion
M
Esser
Jan-Paul
JP
Valkema
Roelf
R
Krenning
Eric P
EP
D000818:Animals; D018278:Carcinoma, Neuroendocrine / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000556:secondary; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007205:Indium Radioisotopes; D008187:Lutetium; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D018579:Patient Selection; D004369:Pentetic Acid / Q000031:analogs & derivatives*; D010456:Peptides, Cyclic; D011788:Quality of Life; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D018000:Receptors, Peptide; D017481:Receptors, Somatostatin; D013004:Somatostatin / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes
D007205:Indium Radioisotopes; D009942:Organometallic Compounds; D010456:Peptides, Cyclic; D019275:Radiopharmaceuticals; D018000:Receptors, Peptide; D017481:Receptors, Somatostatin; D015021:Yttrium Radioisotopes; C470036:octreotate, Tyr(3)-; C071632:SDZ 215-811; D013004:Somatostatin; D008187:Lutetium; D004369:Pentetic Acid; C447941:lutetium Lu 177 dotatate; D015282:Octreotide