title: Peptide receptor radionuclide therapy (PRRT) for GEP-NETs.
abstract: Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues plays an increasing role in the treatment of patients with inoperable or metastasised gatroenteropancreatic neuroendocrine tumours (GEP-NETs). (90)Y-DOTATOC and (177)Lu-DOTATATE are the most used radiopeptides for PRRT with comparable tumour response rates (about 15-35%). The side effects of this therapy are few and mild. However, amino acids should be used for kidney protection, especially during infusion of (90)Y-DOTATOC. Options to improve PRRT may include combinations of radioactive labelled somatostatin analogues and the use of radiosensitising drugs combined with PRRT. Other therapeutic applications of PRRT may include intra-arterial administration, neo-adjuvant treatment and additional PRRT cycles in patients with progressive disease, who have benefited from initial therapy. Considering the mild side-effects, PRRT may well become the first-line therapy in patients with metastasised or inoperable GEP-NETs if more widespread use of PRRT can be accomplished.
authors.affiliation: Department of Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. h.bergsma@erasmusmc.nl
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bergsma
authors.forename: Esther I
authors.initials: EI
authors.lastname: van Vliet
authors.forename: Jaap J M
authors.initials: JJ
authors.lastname: Teunissen
authors.forename: Boen L R
authors.initials: BL
authors.lastname: Kam
authors.forename: Wouter W
authors.initials: WW
authors.lastname: de Herder
authors.forename: Robin P
authors.initials: RP
authors.lastname: Peeters
authors.forename: Eric P
authors.initials: EP
authors.lastname: Krenning
authors.forename: Dik J
authors.initials: DJ
authors.lastname: Kwekkeboom
mesh_terms: D006571:Heterocyclic Compounds / Q000627:therapeutic use; D006573:Heterocyclic Compounds, 1-Ring / Q000627:therapeutic use; D006801:Humans; D007414:Intestinal Neoplasms / Q000378:metabolism / Q000532:radiotherapy*; D018358:Neuroendocrine Tumors / Q000378:metabolism / Q000532:radiotherapy*; D015282:Octreotide / Q000031:analogs & derivatives / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000627:therapeutic use; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D017481:Receptors, Somatostatin / Q000378:metabolism; D019233:Retreatment; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000378:metabolism; D013274:Stomach Neoplasms / Q000378:metabolism / Q000532:radiotherapy*; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
chemical_list: C400086:DOTALAN; D006571:Heterocyclic Compounds; D006573:Heterocyclic Compounds, 1-Ring; D009942:Organometallic Compounds; D010456:Peptides, Cyclic; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D015021:Yttrium Radioisotopes; C116408:yttrium 90-DOTA-lanreotide; D013004:Somatostatin; C447941:lutetium Lu 177 dotatate; D015282:Octreotide; C106246:Edotreotide