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Individualised 177Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry

Sundlöv, Anna LU ; Sjögreen-Gleisner, Katarina LU ; Svensson, Johanna; Ljungberg, Michael LU ; Olsson, Tomas G LU ; Bernhardt, Peter and Tennvall, Jan LU (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
organization
publishing date
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
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
2018-01-07 12:01:48
@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 &gt;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},
  keyword      = {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},
  volume       = {44},
  year         = {2017},
}