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Recombinant alpha-1-microglobulin is a potential kidney protector in 177Lu-octreotate treatment of neuroendocrine tumors

Andersson, Charlotte ; Shubbar, Emman ; Schuler, Emil ; Åkerström, Bo LU ; Gram, Magnus LU orcid and Forssell-Aronsson, Eva (2019) In Journal of Nuclear Medicine 60(11). p.1600-1604
Abstract
Treatment of neuroendocrine tumors with 177Lu-octreotate results in prolonged survival and improved quality of life for the patient. However, the treatment is today limited by side effects on kidney and bone marrow, and complete tumor remission is rarely seen. A possible way to minimize dose-limiting toxicity and to optimize this treatment method is to use radioprotectors in conjunction with radiotherapy. A recombinant form of α1-microglobulin (rA1M) was recently shown to preserve kidney structure and function after 177Lu-octreotate injection in mice and was suggested as a radioprotector in peptide receptor radionuclide therapy. The aims of this work were to investigate the influence of rA1M on the in vivo biokinetics of 177Lu-octreotate,... (More)
Treatment of neuroendocrine tumors with 177Lu-octreotate results in prolonged survival and improved quality of life for the patient. However, the treatment is today limited by side effects on kidney and bone marrow, and complete tumor remission is rarely seen. A possible way to minimize dose-limiting toxicity and to optimize this treatment method is to use radioprotectors in conjunction with radiotherapy. A recombinant form of α1-microglobulin (rA1M) was recently shown to preserve kidney structure and function after 177Lu-octreotate injection in mice and was suggested as a radioprotector in peptide receptor radionuclide therapy. The aims of this work were to investigate the influence of rA1M on the in vivo biokinetics of 177Lu-octreotate, with a focus on tumor tissue, and to study the impact of rA1M on the therapeutic response in tumor tissue subjected to 177Lu-octreotate treatment. Methods: The biodistribution of 177Lu-octreotate was examined in BALB/c nude mice with GOT2 tumors 1-168 h after injection with either 177Lu-octreotate or coadministration of 177Lu-octreotate and rA1M. The effects of rA1M on the tumor response after 177Lu-octreotate treatment were studied in BALB/c nude mice with GOT1 tumors. Three groups of mice were administered rA1M, 177Lu-octreotate, or both. Another group served as untreated controls. Tumor volume was measured to follow the treatment effects. Results: No statistically significant difference in biodistribution of 177Lu was observed between the groups receiving 177Lu-octreotate or coinjection of 177Lu-octreotate and rA1M. The therapy study showed a decrease in mean tumor volume during the first 2 wk for both the 177Lu-octreotate group and the coadministration group, followed by tumor regrowth. No statistically significant difference between the groups was found. Conclusion: rA1M did not negatively impact absorbed dose to tumor or therapeutic response in combination with 177Lu-octreotate and may be a promising kidney protector during 177Lu-octreotate treatment of patients with neuroendocrine tumors. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Nuclear Medicine
volume
60
issue
11
pages
1600 - 1604
publisher
Society of Nuclear Medicine
external identifiers
  • scopus:85074379101
  • pmid:30926650
ISSN
0161-5505
DOI
10.2967/jnumed.118.225243
language
English
LU publication?
yes
id
f39753d5-77fe-4c51-9aed-23c2859f44b6
date added to LUP
2020-07-03 07:11:39
date last changed
2024-05-30 18:59:27
@article{f39753d5-77fe-4c51-9aed-23c2859f44b6,
  abstract     = {{Treatment of neuroendocrine tumors with 177Lu-octreotate results in prolonged survival and improved quality of life for the patient. However, the treatment is today limited by side effects on kidney and bone marrow, and complete tumor remission is rarely seen. A possible way to minimize dose-limiting toxicity and to optimize this treatment method is to use radioprotectors in conjunction with radiotherapy. A recombinant form of α1-microglobulin (rA1M) was recently shown to preserve kidney structure and function after 177Lu-octreotate injection in mice and was suggested as a radioprotector in peptide receptor radionuclide therapy. The aims of this work were to investigate the influence of rA1M on the in vivo biokinetics of 177Lu-octreotate, with a focus on tumor tissue, and to study the impact of rA1M on the therapeutic response in tumor tissue subjected to 177Lu-octreotate treatment. Methods: The biodistribution of 177Lu-octreotate was examined in BALB/c nude mice with GOT2 tumors 1-168 h after injection with either 177Lu-octreotate or coadministration of 177Lu-octreotate and rA1M. The effects of rA1M on the tumor response after 177Lu-octreotate treatment were studied in BALB/c nude mice with GOT1 tumors. Three groups of mice were administered rA1M, 177Lu-octreotate, or both. Another group served as untreated controls. Tumor volume was measured to follow the treatment effects. Results: No statistically significant difference in biodistribution of 177Lu was observed between the groups receiving 177Lu-octreotate or coinjection of 177Lu-octreotate and rA1M. The therapy study showed a decrease in mean tumor volume during the first 2 wk for both the 177Lu-octreotate group and the coadministration group, followed by tumor regrowth. No statistically significant difference between the groups was found. Conclusion: rA1M did not negatively impact absorbed dose to tumor or therapeutic response in combination with 177Lu-octreotate and may be a promising kidney protector during 177Lu-octreotate treatment of patients with neuroendocrine tumors.}},
  author       = {{Andersson, Charlotte and Shubbar, Emman and Schuler, Emil and Åkerström, Bo and Gram, Magnus and Forssell-Aronsson, Eva}},
  issn         = {{0161-5505}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{11}},
  pages        = {{1600--1604}},
  publisher    = {{Society of Nuclear Medicine}},
  series       = {{Journal of Nuclear Medicine}},
  title        = {{Recombinant alpha-1-microglobulin is a potential kidney protector in 177Lu-octreotate treatment of neuroendocrine tumors}},
  url          = {{http://dx.doi.org/10.2967/jnumed.118.225243}},
  doi          = {{10.2967/jnumed.118.225243}},
  volume       = {{60}},
  year         = {{2019}},
}