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Published online: 2020-03-26
Submitted: 2020-02-09
Accepted: 2020-03-15
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Effect of Peptide Receptor Radionuclide Therapy (PRRT) with tandem isotopes – [90Y]Y/[177Lu]Lu-DOTATATE in patients with disseminated neuroendocrine tumours depending on qualification [18F]FDG PET/CT in Polish multicenter experience – do we need [18F]FDG

Anna Zemczak, Maciej Kołodziej, Paweł Gut, Leszek Królicki, Beata Kos-Kudła, Grzegorz Kamiński, Marek Ruchała, Dariusz Pawlak, Jolanta Kunikowska
DOI: 10.5603/EP.a2020.0014
·
Pubmed: 32293704

open access

Ahead of print
Original Paper
Published online: 2020-03-26
Submitted: 2020-02-09
Accepted: 2020-03-15

Abstract

Introduction: Peptide Receptor Radionuclide Therapy (PRRT) using radiolabeled somatostatin analogues is a treatment option for patients with disseminated neuroendocrine tumours (NET). The aim of the study was evaluation the role of [18F]FDG PET/CT in predicting response, progression-free survival (PFS) and overall survival (OS) after tandem therapy [90Y]Y/[177Lu]Lu-DOTATATE. Material and Methods: 75 patients with histopathologically proven NET G1 and G2 were included in the study. Before treatment [68Ga]Ga-DOTATATE PET/CT and [18F]FDG PET/CT was performed. Patients were treated with [90Y]Y/[177Lu]Lu-DOTATATE (1:1) with mixed amino-acid infusion for kidney protection. Results: PFS was 22.2 months for patients [18F]FDG positive and 59.3 months for [18F]FDG negative (p=0.003). The OS from diagnosis (OS-D) and from the start of PRRT (OS-T) was not reached in [18F]FDG negative patients, in [18F]FDG positive patients was 71.8 months and 55.8 months respectively. The observed overall 1-year survival in [18F]FDG positive vs [18F]FDG negative was 96.8% vs 99.1%, 2-year survival 88.9% vs 96%, and 5-year survival was 58.8% vs 88%, respectively. The 1-year and 2-year risk of progression was 15% vs 58.9% in [18F]FDG positive patients and 11% vs 32% in [18F]FDG negative patients. The objective response rate (ORR) [18F]FDG positive vs [18F]FDG negative, was 41.7% vs 17%. Conclusions: [18F]FDG positive patients have statistically significant shorter survival parameters than [18F]FDG negative. The risk of progression in [18F]FDG positive vs [18F]FDG negative patients in one year follow up is comparable whereas in two-year follow up is nearly 2 times higher for [18F]FDG PET/CT positive patients.

Abstract

Introduction: Peptide Receptor Radionuclide Therapy (PRRT) using radiolabeled somatostatin analogues is a treatment option for patients with disseminated neuroendocrine tumours (NET). The aim of the study was evaluation the role of [18F]FDG PET/CT in predicting response, progression-free survival (PFS) and overall survival (OS) after tandem therapy [90Y]Y/[177Lu]Lu-DOTATATE. Material and Methods: 75 patients with histopathologically proven NET G1 and G2 were included in the study. Before treatment [68Ga]Ga-DOTATATE PET/CT and [18F]FDG PET/CT was performed. Patients were treated with [90Y]Y/[177Lu]Lu-DOTATATE (1:1) with mixed amino-acid infusion for kidney protection. Results: PFS was 22.2 months for patients [18F]FDG positive and 59.3 months for [18F]FDG negative (p=0.003). The OS from diagnosis (OS-D) and from the start of PRRT (OS-T) was not reached in [18F]FDG negative patients, in [18F]FDG positive patients was 71.8 months and 55.8 months respectively. The observed overall 1-year survival in [18F]FDG positive vs [18F]FDG negative was 96.8% vs 99.1%, 2-year survival 88.9% vs 96%, and 5-year survival was 58.8% vs 88%, respectively. The 1-year and 2-year risk of progression was 15% vs 58.9% in [18F]FDG positive patients and 11% vs 32% in [18F]FDG negative patients. The objective response rate (ORR) [18F]FDG positive vs [18F]FDG negative, was 41.7% vs 17%. Conclusions: [18F]FDG positive patients have statistically significant shorter survival parameters than [18F]FDG negative. The risk of progression in [18F]FDG positive vs [18F]FDG negative patients in one year follow up is comparable whereas in two-year follow up is nearly 2 times higher for [18F]FDG PET/CT positive patients.

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Keywords

PRRT; [90Y]Y/[177Lu]Lu-DOTATATE; [18F]FDG PET/CT; tandem therapy; neuroendocrine tumours.

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About this article
Title

Effect of Peptide Receptor Radionuclide Therapy (PRRT) with tandem isotopes – [90Y]Y/[177Lu]Lu-DOTATATE in patients with disseminated neuroendocrine tumours depending on qualification [18F]FDG PET/CT in Polish multicenter experience – do we need [18F]FDG

Journal

Endokrynologia Polska

Issue

Ahead of print

Published online

2020-03-26

DOI

10.5603/EP.a2020.0014

Pubmed

32293704

Keywords

PRRT
[90Y]Y/[177Lu]Lu-DOTATATE
[18F]FDG PET/CT
tandem therapy
neuroendocrine tumours.

Authors

Anna Zemczak
Maciej Kołodziej
Paweł Gut
Leszek Królicki
Beata Kos-Kudła
Grzegorz Kamiński
Marek Ruchała
Dariusz Pawlak
Jolanta Kunikowska

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