Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours

Romer, A.; Seiler, D.; Marincek, Nicolas; Brunner, P.; Koller, M. T.; Ng, Quinn Kwan-Tai; Maecke, H. R.; Müller-Brand, J.; Rochlitz, C.; Briel, M.; Schindler, C.; Walter, Martin Alexander (2014). Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours. European journal of nuclear medicine and molecular imaging, 41(2), pp. 214-222. Springer 10.1007/s00259-013-2559-8

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PURPOSE Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides (90)Y or (177)Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. METHODS In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [(90)Y-DOTA]-TOC or [(177)Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. RESULTS Overall, 910 patients underwent 1,804 cycles of [(90)Y-DOTA]-TOC and 141 patients underwent 259 cycles of [(177)Lu-DOTA]-TOC. The median survival after [(177)Lu-DOTA]-TOC and after [(90)Y-DOTA]-TOC was comparable (45.5 months versus 35.9 months, hazard ratio 0.91, 95% confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [(177)Lu-DOTA]-TOC over [(90)Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [(177)Lu-DOTA]-TOC treatment (1.4 vs 10.1%, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8%, p = 0.32). CONCLUSION The present results revealed no difference in median overall survival after [(177)Lu-DOTA]-TOC and [(90)Y-DOTA]-TOC. Furthermore, [(177)Lu-DOTA]-TOC was less haematotoxic than [(90)Y-DOTA]-TOC.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine

UniBE Contributor:

Marincek, Nicolas; Ng, Quinn Kwan-Tai and Walter, Martin Alexander

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1619-7070

Publisher:

Springer

Language:

English

Submitter:

Franziska Nicoletti

Date Deposited:

13 Oct 2014 09:08

Last Modified:

20 Mar 2018 13:23

Publisher DOI:

10.1007/s00259-013-2559-8

PubMed ID:

24085501

BORIS DOI:

10.7892/boris.48317

URI:

https://boris.unibe.ch/id/eprint/48317

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