title: 177Lu-DOTATATE molecular radiotherapy for childhood neuroblastoma.
abstract: This study tested the principle that (68)Ga-DOTATATE PET/CT may be used to select children with primary refractory or relapsed high-risk neuroblastoma for treatment with (177)Lu-DOTATATE and evaluated whether this is a viable therapeutic option for those children.
  
  
  METHODS
  Between 2008 and 2010, 8 children with relapsed or refractory high-risk neuroblastoma were studied with (68)Ga-DOTATATE PET/CT. The criterion of eligibility for (177)Lu-DOTATATE therapy was uptake on the diagnostic scan equal to or higher than that of the liver.
  
  
  RESULTS
  Of the 8 children imaged, 6 had abnormally high uptake on the (68)Ga-DOTATATE PET/CT scan and proceeded to treatment. Patients received 2 or 3 administrations of (177)Lu-DOTATATE at a median interval of 9 wk and a median administered activity of 7.3 GBq. Of the 6 children treated, 5 had stable disease by the response evaluation criteria in solid tumors (RECIST). Of these 5 children, 2 had an initial metabolic response and reduction in the size of their lesions, and 1 patient had a persistent partial metabolic response and reduction in size of the lesions on CT, although the disease was stable by RECIST. One had progressive disease. Three children had grade 3 and 1 child had grade 4 thrombocytopenia. No significant renal toxicity has been seen.
  
  
  CONCLUSIONS
  (68)Ga-DOTATATE can be used to image children with neuroblastoma and identify those suitable for molecular radiotherapy with (177)Lu-DOTATATE. We have shown, for what is to our knowledge the first time, that treatment with (177)Lu-DOTATATE is safe and feasible in children with relapsed or primary refractory high-risk neuroblastoma. We plan to evaluate this approach formally in a phase I-II clinical trial.
authors.affiliation: Department of Oncology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Gains
authors.forename: Jamshed B
authors.initials: JB
authors.lastname: Bomanji
authors.forename: Naomi L
authors.initials: NL
authors.lastname: Fersht
authors.forename: Tracy
authors.initials: T
authors.lastname: Sullivan
authors.forename: Derek
authors.initials: D
authors.lastname: D'Souza
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Sullivan
authors.forename: Matthew
authors.initials: M
authors.lastname: Aldridge
authors.forename: Wendy
authors.initials: W
authors.lastname: Waddington
authors.forename: Mark N
authors.initials: MN
authors.lastname: Gaze
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000378:metabolism / Q000532:radiotherapy*; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D017481:Receptors, Somatostatin / Q000378:metabolism; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005710:Gallium Radioisotopes; D009942:Organometallic Compounds; D017481:Receptors, Somatostatin; C447941:lutetium Lu 177 dotatate; D015282:Octreotide