Neuroendocrine tumors. Peptide receptor radionuclide therapy.
Peptide receptor radionuclide therapy with radiolabelled somatostatin analogues is an emerging and convincing treatment modality for patients with unresectable, somatostatin-receptor-positive neuroendocrine tumours. Using radiolabelled somatostatin analogues for imaging became the gold standard for staging of neuroendocrine tumours. The somatostatin receptor is strongly over-expressed in most tumours, resulting in high tumour-to-background ratios. Consequently, the next step was to try to treat these patients by increasing the radioactivity of the administered radiolabelled somatostatin analogue in an attempt to bring about tumour cure. Many patients have been treated successfully with this approach, roughly 25% of them achieving objective tumour shrinkage >50%. Serious side-effects have been rare. This article reviews the effectiveness and safety of the different radiolabelled somatostatin analogues used. Furthermore, clinical issues--including indication and timing of therapy--are discussed. Finally, important directions for future research are mentioned to illustrate new strategies for increasing therapy efficacy.
Forrer
Flavio
F
Department of Nuclear Medicine, Erasmus Medical Centre Rotterdam, Dr Molewaterplein 40, NL-3015 GD Rotterdam, The Netherlands.
Valkema
Roelf
R
Kwekkeboom
Dik J
DJ
de Jong
Marion
M
Krenning
Eric P
EP
D001769:Blood / Q000187:drug effects; D006571:Heterocyclic Compounds / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008099:Liver / Q000187:drug effects; D018358:Neuroendocrine Tumors / Q000628:therapy*; D015282:Octreotide / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000009:adverse effects / Q000627:therapeutic use; D004369:Pentetic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D011868:Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D018000:Receptors, Peptide / Q000627:therapeutic use*; D013004:Somatostatin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D013997:Time Factors
D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; D011868:Radioisotopes; D018000:Receptors, Peptide; C113625:yttrium(III)-1,4,7,10-tetraazacyclotetradecane-N,N',N'',N'''-tetraacetic acid; C071632:SDZ 215-811; D013004:Somatostatin; D004369:Pentetic Acid; D015282:Octreotide; C106246:Edotreotide