title: Lutetium-labelled peptides for therapy of neuroendocrine tumours.
abstract: Treatment with radiolabelled somatostatin analogues is a promising new tool in the management of patients with inoperable or metastasized neuroendocrine tumours. Symptomatic improvement may occur with (177)Lu-labelled somatostatin analogues that have been used for peptide receptor radionuclide therapy (PRRT). The results obtained with (177)Lu-[DOTA(0),Tyr(3)]octreotate (DOTATATE) are very encouraging in terms of tumour regression. Dosimetry studies with (177)Lu-DOTATATE as well as the limited side effects with additional cycles of (177)Lu-DOTATATE suggest that more cycles of (177)Lu-DOTATATE can be safely given. Also, if kidney-protective agents are used, the side effects of this therapy are few and mild and less than those from the use of (90)Y-[DOTA(0),Tyr(3)]octreotide (DOTATOC). Besides objective tumour responses, the median progression-free survival is more than 40 months. The patients' self-assessed quality of life increases significantly after treatment with (177)Lu-DOTATATE. Lastly, compared to historical controls, there is a benefit in overall survival of several years from the time of diagnosis in patients treated with (177)Lu-DOTATATE. These findings compare favourably with the limited number of alternative therapeutic approaches. If more widespread use of PRRT can be guaranteed, such therapy may well become the therapy of first choice in patients with metastasized or inoperable neuroendocrine tumours.
authors.affiliation: Department of Nuclear Medicine, Erasmus MC, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. b.kam@erasmusmc.nl
authors.forename: B L R
authors.initials: BL
authors.lastname: Kam
authors.forename: J J M
authors.initials: JJ
authors.lastname: Teunissen
authors.forename: E P
authors.initials: EP
authors.lastname: Krenning
authors.forename: W W
authors.initials: WW
authors.lastname: de Herder
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.forename: E I
authors.initials: EI
authors.lastname: van Vliet
authors.forename: D J
authors.initials: DJ
authors.lastname: Kwekkeboom
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D008187:Lutetium / Q000627:therapeutic use*; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000532:radiotherapy*; D015282:Octreotide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D010455:Peptides / Q000627:therapeutic use*; D011868:Radioisotopes / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D017481:Receptors, Somatostatin / Q000378:metabolism; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D009942:Organometallic Compounds; D010455:Peptides; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D013004:Somatostatin; D008187:Lutetium; C447941:lutetium Lu 177 dotatate; D015282:Octreotide