Polish experience in Peptide receptor radionuclide therapy.
METHODS
During the period from April 2004 to December 2010, 358 patients underwent peptide receptor radionuclide therapy (PRRT) ((90)Y-DOTATATE, (177)Lu-DOTATATE, and (90)Y/(177)Lu-DOTATATE) in Poland.


RESULTS
The majority of patients underwent (90)Y-DOTATATE therapy (n = 177) with progression-free survival (PFS)/time to progression (TTP) of 17-44 months and overall survival (OS) of 22-34.2 months. Twelve-month follow-up revealed stable disease (SD) in 46-60%, disease regression (RD) in 16-35%, disease progression (PD) in 7-17%, and complete remission (CR) in 3% of patients. In patients treated with (90)Y/(177)Lu-DOTATATE (n = 44), PFS/TTP was 24.2-28.3 months and OS was 49.8-52.8 months. Twelve-month follow-up showed SD in 62-70%, RD in 15-20%, and PD in 10-12% of patients. The treatment was well tolerated. No severe adverse events occurred. Grade 3 toxicity [in leucocytes (WBC) and thrombocytes (PLT)] was seen in 6-20% of patients treated with (90)Y-DOTATATE. In that group, renal toxicity grade 3 was seen in 5-12% and grade 4 in 3-8%. In patients treated with tandem therapy with (90)Y/(177)Lu-DOTATATE or (177)Lu-DOTATATE alone, hematological and renal toxicity grade 3 or 4 was not observed.


CONCLUSIONS
The results indicate that PRRT with the procedures and isotopes used is an effective and safe therapy option for patients with metastatic or inoperable neuroendocrine tumors (NETs). Our results suggest that tandem therapy with (90)Y/(177)Lu-DOTATATE provides longer overall survival than single-isotope treatment. Hematological toxicity was rare in all treated patients. Renal toxicity grade 3 and 4 was observed only in the group treated with (90)Y-DOTATATE.
Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland. jolanta.kunikowska@wum.edu.pl
Jolanta
J
Kunikowska
Leszek
L
Królicki
Anna
A
Sowa-Staszczak
Alicja
A
Hubalewska-Dydejczyk
Dariusz
D
Pawlak
Renata
R
Mikolajczak
Daria
D
Handkiewicz-Junak
Norbert
N
Szaluś
Grzegorz
G
Kamiński
Jaroslaw
J
Cwikla
Maciej
M
Jakuciński
Anna
A
Lukiewicz
Aldona
A
Kowalska
Pawel
P
Gut
D006801:Humans; D008187:Lutetium / Q000627:therapeutic use*; D018358:Neuroendocrine Tumors / Q000737:chemistry / Q000401:mortality / Q000532:radiotherapy*; D015282:Octreotide / Q000031:analogs & derivatives / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D011868:Radioisotopes / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000009:adverse effects / Q000627:therapeutic use*; D017481:Receptors, Somatostatin / Q000032:analysis*; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D009942:Organometallic Compounds; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D015021:Yttrium Radioisotopes; D008187:Lutetium; C447941:lutetium Lu 177 dotatate; D015282:Octreotide