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Clinical Applications of Nuclear Medicine Targeted Therapy pp 289–295Cite as

PRRT with Radiolabeled Peptides: Indications, Procedures, and Results

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Abstract

Peptide receptor radionuclide therapy (PRRT) is an effective and usually well-tolerated treatment for unresectable or metastatic neuroendocrine tumors expressing somatostatin receptors. The two radiopharmaceuticals most commonly used for PRRT are 90Y-DOTATOC and 177Lu-DOTATATE which have been demonstrated to provide effective tumor response and symptom relief and have positive impact on survival. Chronic side effects on the kidneys and bone marrow are generally mild. Future perspectives include combinations with innovative therapeutic agents or the use of alpha-emitting radionuclide to improve PRRT efficacy.

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References

  1. Cives M, Strosberg J. An update on gastroenteropancreatic neuroendocrine tumors. Oncology (Williston Park). 2014;28(9):749–56, 758.

    Google Scholar 

  2. Yao JC, Hassan M, Phan A, et al. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;26(18):3063–72.

    Article  PubMed  Google Scholar 

  3. Kaltsas GA, Besser GM, Grossman AB. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004;25:458–511.

    Article  CAS  PubMed  Google Scholar 

  4. Kulke MH, Benson AB 3rd, Bergsland E, et al. Neuroendocrine tumors. J Natl Compr Canc Netw. 2012;10:724–64.

    Article  CAS  PubMed  Google Scholar 

  5. Castellano D, Grande E, Valle J, Capdevila J, Reidy-Lagunes D, O’Connor JM, Raymond E. Expert consensus for the management of advanced or metastatic pancreatic neuroendocrine and carcinoid tumors. Cancer Chemother Pharmacol. 2015;75(6):1099–114.

    Article  CAS  PubMed  Google Scholar 

  6. van der Zwan WA, Bodei L, Mueller-Brand J, et al. GEPNETs update: radionuclide therapy in neuroendocrine tumors. Eur J Endocrinol. 2015;172(1):R1–8.

    Article  PubMed  Google Scholar 

  7. Strosberg J, El-Haddad G, Wolin E, NETTER-1 Trial Investigators, et al. Phase 3 trial of (177)lu-dotatate for midgut neuroendocrine tumors. N Engl J Med. 2017;376(2):125–35.

    Article  CAS  PubMed  Google Scholar 

  8. Reubi JC, Schar JC, Waser B, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000;27:273–82.

    Article  CAS  PubMed  Google Scholar 

  9. Volkert WA, Hoffman TJ. Thrapeutic radiopharmaceuticals. Chem Rev. 1999;99:2269–92.

    Article  CAS  PubMed  Google Scholar 

  10. Krenning EP, Kwekkeboom DJ, Bakker WH, et al. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med. 1993;20:716–31.

    Article  CAS  PubMed  Google Scholar 

  11. Kratochwil C, Stefanova M, Mavriopoulou E, et al. SUV of [68Ga]DOTATOC-PET/CT predicts response probability of PRRT in neuroendocrine tumors. Mol Imaging Biol. 2015;17(3):313–8.

    Article  CAS  PubMed  Google Scholar 

  12. Kwekkeboom DJ, de Herder WW, Kam BL, et al. Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0, Tyr3]octreotate: toxicity, efficacy, and survival. J Clin Oncol. 2008;26:2124–30.

    Article  CAS  PubMed  Google Scholar 

  13. Imhof A, Brunner P, Marincek N, et al. Response, survival, and long-termtoxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers. J Clin Oncol. 2011;29:2416–23.

    Article  CAS  PubMed  Google Scholar 

  14. Sansovini M, Severi S, Ambrosetti A, et al. Treatment with the radiolabelled somatostatin analog Lu- DOTATATE for advanced pancreatic neuroendocrine tumors. Neuroendocrinology. 2013;97:347–54.

    Article  CAS  PubMed  Google Scholar 

  15. Kwekkeboom DJ, Teunissen JJ, Bakker WH, et al. Radiolabeled somatostatin analog [177Lu DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors. J Clin Oncol. 2005;23(12):2754–62.

    Article  CAS  PubMed  Google Scholar 

  16. De Keizer B, van Aken MO, Feelders RA, et al. Hormonal crises following receptor radionuclide therapy with the radiolabeled somatostatin analogue [177Lu-DOTA0,Tyr3]octreotate. Eur J Nucl Med Mol Imaging. 2008;35:749e55.

    Article  Google Scholar 

  17. Bodei L, Kidd M, Paganelli G, et al. Long-term tolerability of PRRT in 807 patients with neuroendocrine tumours: the value and limitations of clinical factors. Eur J Nucl Med Mol Imaging. 2015;42:5e19.

    Google Scholar 

  18. Gupta SK, Singla S, Bal C. Renal and hematological toxicity in patients of neuroendocrine tumors after peptide receptor radionuclide therapy with 177Lu-DOTATATE. Cancer Biother Radiopharm. 2012;27:593.

    Article  CAS  PubMed  Google Scholar 

  19. Rolleman EJ, Valkema R, de Jong M, et al. Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine. Eur J Nucl Med Mol Imaging. 2003;30:9.

    Article  CAS  PubMed  Google Scholar 

  20. Jamar F, Barone R, Mathieu I, et al. (86Y-DOTA0)-D-Phe1-Tyr3-octreotide (SMT487)ea phase 1 clinical study: pharmacokinetics,biodistribution and renal protective effect of different regimens of amino acid co-infusion. Eur J Nucl Med Mol Imaging. 2003;30:510.

    Article  CAS  PubMed  Google Scholar 

  21. Bodei L, Cremonesi M, Ferrari M, et al. Long-term evaluation of renal toxicity after peptide receptor radionuclide therapy with 90Y-DOTATOC and 177Lu-DOTATATE: the role of associated risk factors. Eur J Nucl Med Mol Imaging. 2008;35:1847.

    Article  CAS  PubMed  Google Scholar 

  22. Brabander T, Teunissen JJ, Van Eijck CH, et al. Peptide receptor radionuclide therapy of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab. 2016;30(1):103–14.

    Article  CAS  PubMed  Google Scholar 

  23. Kim SJ, Pak K, Koo PJ, Kwak JJ, Chang S. The efficacy of (177)Lu-labelled peptide receptor radionuclide therapy in patients with neuroendocrine tumours: a meta-analysis. Eur J Nucl Med Mol Imaging. 2015;42(13):1964–70.

    Article  CAS  PubMed  Google Scholar 

  24. Khan S, Krenning EP, van Essen M, et al. Quality of life in 265 patients with gastroenteropancreatic or bronchial neuroendocrine tumors treated with [177Lu-DOTA0,Tyr3]octreotate. J Nucl Med. 2011;52(9):1361–8.

    Article  CAS  PubMed  Google Scholar 

  25. Mariniello A, Bodei L, Tinelli C, et al. Long-term results of PRRT in advanced bronchopulmonary carcinoid. Eur J Nucl Med Mol Imaging. 2016;43(3):441–52.

    Article  CAS  PubMed  Google Scholar 

  26. Kratochwil C, Giesel FL, Bruchertseifer F, et al. 213Bi-DOTATOC receptor-targeted alpha-radionuclide therapy induces remission in neuroendocrine tumours refractory to beta radiation: a first-in-human experience. Eur J Nucl Med Mol Imaging. 2014;41:2106.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Wild D, Fani M, Fischer R, et al. Comparison of somatostatin receptor agonist and antagonist for peptide receptor radionuclide therapy: a pilot study. J Nucl Med. 2014;55(8):1248–52.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Nuclear Medicine, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy

    Ettore Seregni & Alice Lorenzoni

Authors
  1. Ettore Seregni
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  2. Alice Lorenzoni
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Corresponding author

Correspondence to Ettore Seregni .

Editor information

Editors and Affiliations

  1. Department of Nuclear Medicine, Humanitas Gavazzeni Hospital, Bergamo, Italy

    Emilio Bombardieri

  2. Nuclear Medicine Therapy and Endocrinology, Istituto Nazionale dei Tumori, Milano, Italy

    Ettore Seregni

  3. Nuclear Medicine and Molecular Imaging Unit, Veneto Institute of Oncology IOV - IRCCS, Padova, Italy

    Laura Evangelista

  4. Nuclear Medicine Division, Istituto Nazionale dei Tumori, Milano, Italy

    Carlo Chiesa

  5. Nuclear Medicine, Humanitas Research Hospital, Rozzano, Milano, Italy

    Arturo Chiti

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Seregni, E., Lorenzoni, A. (2018). PRRT with Radiolabeled Peptides: Indications, Procedures, and Results. In: Bombardieri, E., Seregni, E., Evangelista, L., Chiesa, C., Chiti, A. (eds) Clinical Applications of Nuclear Medicine Targeted Therapy . Springer, Cham. https://doi.org/10.1007/978-3-319-63067-0_22

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  • DOI: https://doi.org/10.1007/978-3-319-63067-0_22

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63066-3

  • Online ISBN: 978-3-319-63067-0

  • eBook Packages: MedicineMedicine (R0)

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