Individualised 177Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry
(2017) In European Journal of Nuclear Medicine and Molecular Imaging 44(9). p.1480-1489- Abstract
Purpose: To present data from an interim analysis of a Phase II trial designed to determine the feasibility, safety, and efficacy of individualising treatment based on renal dosimetry, by giving as many cycles as possible within a maximum renal biologically effective dose (BED). Method: Treatment was given with repeated cycles of 7.4 GBq 177Lu-DOTATATE at 8-12-week intervals. Detailed dosimetry was performed in all patients after each cycle using a hybrid method (SPECT + planar imaging). All patients received treatment up to a renal BED of 27 ± 2 Gy (α/β = 2.6 Gy) (Step 1). Selected patients were offered further treatment up to a renal BED of 40 ± 2 Gy (Step 2). Renal function was followed by estimation and measurement of the... (More)
Purpose: To present data from an interim analysis of a Phase II trial designed to determine the feasibility, safety, and efficacy of individualising treatment based on renal dosimetry, by giving as many cycles as possible within a maximum renal biologically effective dose (BED). Method: Treatment was given with repeated cycles of 7.4 GBq 177Lu-DOTATATE at 8-12-week intervals. Detailed dosimetry was performed in all patients after each cycle using a hybrid method (SPECT + planar imaging). All patients received treatment up to a renal BED of 27 ± 2 Gy (α/β = 2.6 Gy) (Step 1). Selected patients were offered further treatment up to a renal BED of 40 ± 2 Gy (Step 2). Renal function was followed by estimation and measurement of the glomerular filtration rate (GFR). Results: Fifty-one patients were included in the present analysis. Among the patients who received treatment as planned, the median number of cycles in Step 1 was 5 (range 3-7), and for those who completed Step 2 it was 7 (range 5-8); 73% were able to receive >4 cycles. Although GFR decreased in most patients after the completion of treatment, no grade 3-4 toxicity was observed. Patients with a reduced baseline GFR seemed to have an increased risk of GFR decline. Five patients received treatment in Step 2, none of whom exhibited a significant reduction in renal function. Conclusions: Individualising PRRT using renal dosimetry seems feasible and safe and leads to an increased number of cycles in the majority of patients. The trial will continue as planned.
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- author
- Sundlöv, Anna LU ; Sjögreen-Gleisner, Katarina LU ; Svensson, Johanna ; Ljungberg, Michael LU ; Olsson, Tomas G LU ; Bernhardt, Peter and Tennvall, Jan LU
- organization
- publishing date
- 2017-03-22
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Lu-DOTATATE, Dosimetry, Neuroendocrine, PRRT, Renal function
- in
- European Journal of Nuclear Medicine and Molecular Imaging
- volume
- 44
- issue
- 9
- pages
- 1480 - 1489
- publisher
- Springer
- external identifiers
-
- scopus:85015937031
- wos:000405459500009
- pmid:28331954
- ISSN
- 1619-7070
- DOI
- 10.1007/s00259-017-3678-4
- language
- English
- LU publication?
- yes
- id
- 131c9a97-ed98-4d89-b9b4-b9453ee05fc4
- date added to LUP
- 2017-05-03 17:35:32
- date last changed
- 2024-12-10 10:52:32
@article{131c9a97-ed98-4d89-b9b4-b9453ee05fc4, abstract = {{<p>Purpose: To present data from an interim analysis of a Phase II trial designed to determine the feasibility, safety, and efficacy of individualising treatment based on renal dosimetry, by giving as many cycles as possible within a maximum renal biologically effective dose (BED). Method: Treatment was given with repeated cycles of 7.4 GBq <sup>177</sup>Lu-DOTATATE at 8-12-week intervals. Detailed dosimetry was performed in all patients after each cycle using a hybrid method (SPECT + planar imaging). All patients received treatment up to a renal BED of 27 ± 2 Gy (α/β = 2.6 Gy) (Step 1). Selected patients were offered further treatment up to a renal BED of 40 ± 2 Gy (Step 2). Renal function was followed by estimation and measurement of the glomerular filtration rate (GFR). Results: Fifty-one patients were included in the present analysis. Among the patients who received treatment as planned, the median number of cycles in Step 1 was 5 (range 3-7), and for those who completed Step 2 it was 7 (range 5-8); 73% were able to receive >4 cycles. Although GFR decreased in most patients after the completion of treatment, no grade 3-4 toxicity was observed. Patients with a reduced baseline GFR seemed to have an increased risk of GFR decline. Five patients received treatment in Step 2, none of whom exhibited a significant reduction in renal function. Conclusions: Individualising PRRT using renal dosimetry seems feasible and safe and leads to an increased number of cycles in the majority of patients. The trial will continue as planned.</p>}}, author = {{Sundlöv, Anna and Sjögreen-Gleisner, Katarina and Svensson, Johanna and Ljungberg, Michael and Olsson, Tomas G and Bernhardt, Peter and Tennvall, Jan}}, issn = {{1619-7070}}, keywords = {{Lu-DOTATATE; Dosimetry; Neuroendocrine; PRRT; Renal function}}, language = {{eng}}, month = {{03}}, number = {{9}}, pages = {{1480--1489}}, publisher = {{Springer}}, series = {{European Journal of Nuclear Medicine and Molecular Imaging}}, title = {{Individualised <sup>177</sup>Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry}}, url = {{http://dx.doi.org/10.1007/s00259-017-3678-4}}, doi = {{10.1007/s00259-017-3678-4}}, volume = {{44}}, year = {{2017}}, }