Survival and Response Outcomes for Gastrointestinal Neuroendocrine Tumor (GEP-NETs) Patients Treated with Lutetium—177-DOTATATE in a Brazilian Reference Center: A Six-Year Follow-Up Experience

SIMPLE SUMMARY: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are the most common primary site of NETs. Peptide receptor radiation therapy with Lutetium-177-DOTATATE (PRRT) is the standard treatment for grade 1 (G1) or grade 2 (G2) midgut NETs when somatostatin analog therapy fails, but li...

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Detalles Bibliográficos
Autores principales: de Souza, Zenaide Silva, Xavier, Camila Bragança, Gomes, Luciana Beatriz Mendes, de Medeiros, Maria Fernanda Barbosa, de Sousa, Micelange Carvalho, Pereira, Allan Andresson Lima, Marin, José Flávio Gomes, Buchpiguel, Carlos Alberto, Costa, Frederico Perego
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Communication
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10526125/
https://www.ncbi.nlm.nih.gov/pubmed/37760475
http://dx.doi.org/10.3390/cancers15184506
Descripción
Sumario:SIMPLE SUMMARY: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are the most common primary site of NETs. Peptide receptor radiation therapy with Lutetium-177-DOTATATE (PRRT) is the standard treatment for grade 1 (G1) or grade 2 (G2) midgut NETs when somatostatin analog therapy fails, but limited data exists on all-grade GEP-NETs, especially for grade 3 (G3) tumors. Here, we aimed to review the clinical-pathological and radiological characteristics of those tumors and correlate them with outcomes. That might help with how to select patients for PPRT. ABSTRACT: Background: PRRT can be an option for all-grade GEP-NETs, but selecting patients is challenging. In this scenario, clinical-pathological and radiological characteristics, such as pre-treatment Ga-68 DOTA PET/CT, might have the potential to help. Methods: A retrospective chart review was conducted on advanced GEP-NETs treated with at least one PRRT dose. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan–Meier method. Krenning Score (KS), and the maximum standardized uptake value (SUVmax) were derived from the pre-treatment scans. A maximally selected rank statistics test was used for SUVmax simple cut point estimate. Results: Among 36 patients, 19 had primary pancreatic tumors. The numbers of G1, G2, and G3 tumors were 10, 18, and 7, respectively. During a median follow-up of 90.5 months, 4 patients died. Median OS was not reached for G1 and G2 tumors, and it was 30 months for G3 (p = 0.001). Median PFS was 23 months, with G3 showing lower PFS compared to G1 [7 versus 30 months; HR 8.41 (95%CI 2.2–31.0; p = 0.001)]. Conclusions: PRRT provides long-term PFS in patients with G1/G2 GEP-NETs independent of clinical characteristics and primary site. G3 has worse survival, but selected patients may experience long OS after PRRT treatment.

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