title: Effectiveness of radiolabelled somatostatin analogues (90Y-DOTATOC and177Lu-DOTATATE) in patients with metastatic neuroendocrine tumours: a single centre experience in Mexico.
abstract: OBJECTIVE
  To determine the effectiveness of therapy with the radiolabelled somatostatin analogues,90Y-DOTATOC and177Lu-DOTATATE, in the treatment of metastatic neuroendocrine tumours with progression to first-line treatment.
  
  
  METHODS
  A study was conducted on 30 patients diagnosed with neuroendocrine tumours (gastroenteropancreatic, bronchopulmonary, MEN2A, MEN2B, phaeochromocytoma, and paraganglioma) with metastatic disease diagnosed by the pathology department, with progression to first-line treatment, and recruited from December 2014 to February 2016. Efficacy was analysed using computed tomography (CT) according RECIST 1.1 criteria, and the molecular changes using the SUVmax of PET/CT with68Ga-DOTATOC. Safety was carried out with a renal scan with99mTc-MAG3.
  
  
  RESULTS
  The 30 patients received a total of 49 cycles90Y-DOTATOC (21 doses) and177Lu-DOTATATE (28 doses), with a mean of 1.5 cycles per patient. Of these, 17 (56.7%) showed a partial morphological response, 22 (73.3%) molecular and biochemical response, and 23 (76.6%) clinical response. One patient died during the median follow-up of 13 months. The median overall survival from diagnosis was 54 months (95% CI; 31.18-76.81), and median progression-free survival was 32 months (95% CI; 15.00-48.99).
  
  
  CONCLUSIONS
  Therapy with90Y-DOTATOC and177Lu-DOTATATE is a promising therapy for patients with well and moderately differentiated neuroendocrine tumours. The efficacy is better the larger the number of cycles administered, inversely proportional to the number of metastases (<10), and is associated with the level of uptake according to the SUVmax by the metastases, regardless of metabolically active tumour volume.
authors.affiliation: Departamento de Medicina e Imagen Molecular, Instituto Nacional de Cancerología, Ciudad de México, México. Electronic address: dr.sevastian@outlook.com.
authors.forename: S S
authors.initials: SS
authors.lastname: Medina-Ornelas
authors.affiliation: Departamento de Medicina e Imagen Molecular, Instituto Nacional de Cancerología, Ciudad de México, México.
authors.forename: F O
authors.initials: FO
authors.lastname: García-Pérez
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D015282:Octreotide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies; D013004:Somatostatin / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D055815:Young Adult; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D013004:Somatostatin; C496730:90Y-octreotide, DOTA-Tyr(3)-; C447941:lutetium Lu 177 dotatate; D015282:Octreotide
keywords: (177)Lu-DOTATATE; (68)Ga-DOTATOC PET/CT; (68)Ga-DOTATOC PET/TC; (90)Y-DOTATOC; Análogos de somatostatina radiomarcados; Neuroendocrine tumours; Radiolabelled somatostatin analogues; Tumores neuroendocrinos