title: Peptide receptor radionuclide therapy with Y-DOTATOC and (177)Lu-DOTATOC in advanced neuroendocrine tumors: results from a Danish cohort treated in Switzerland.
abstract: OBJECTIVE
  Limited therapeutic options have highlighted the demand for new treatment modalities for patients with advanced neuroendocrine tumors (NET). Promising results of initial studies have warranted the implementation of peptide receptor radionuclide therapy (PRRT) in clinical practice. However, this treatment option still needs clinical evaluation.
  
  
  METHODS
  In this study, we evaluated the PRRT treatment response of 69 Danish patients with NET mainly originating from the gastroenteropancreatic system. Fifty-six patients (81%) were referred for PRRT to the Department of Nuclear Medicine, University Hospital Basel, Switzerland, between 2004 and 2008 due to progression assessed by the referring physicians. However, when retrospectively evaluated, only 42 of the 69 patients (61%) had progression according to RECIST (Response Evaluation Criteria in Solid Tumors). Most patients were treated with ⁹⁰Y-DOTATOC.
  
  
  RESULTS
  Based on RECIST, a complete response was observed in 5 patients (7.4%), a partial response in 11 patients (16.2%) and stable disease in 42 patients (61.8%). Progressive disease after completed therapy was observed in 10 patients (14.7%). The median progression-free survival was 29 months (95% CI: 22-36 months). Pancreatic NET seemed to respond better to PRRT than small intestinal carcinoid tumors (p = 0.03). The overall frequency of serious adverse events was low.
  
  
  CONCLUSIONS
  Implementation of PRRT in clinical routine has provided a valuable new therapeutic option for the treatment of advanced NET. We suggest that PRRT may advance from second- or third-line to first- or second-line therapy in inoperable/unresectable NET patients.
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine and PET, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Andreas Klaus
authors.initials: AK
authors.lastname: Pfeifer
authors.forename: Tine
authors.initials: T
authors.lastname: Gregersen
authors.forename: Henning
authors.initials: H
authors.lastname: Grønbæk
authors.forename: Carsten Palnæs
authors.initials: CP
authors.lastname: Hansen
authors.forename: Jan
authors.initials: J
authors.lastname: Müller-Brand
authors.forename: Karin
authors.initials: K
authors.lastname: Herskind Bruun
authors.forename: Klaus
authors.initials: K
authors.lastname: Krogh
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjær
authors.forename: Ulrich
authors.initials: U
authors.lastname: Knigge
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D018000:Receptors, Peptide; D012189:Retrospective Studies; D013557:Switzerland; D016896:Treatment Outcome
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D018000:Receptors, Peptide; C496730:90Y-octreotide, DOTA-Tyr(3)-; C447941:lutetium Lu 177 dotatate; D015282:Octreotide