Efficacy of [177Lu]Lu-DOTATATE in metastatic neuroendocrine neoplasms of different locations: data from the SEPTRALU study

BackgroundPeptide receptor radionuclide therapy (PRRT) is one of the most promising therapeutic strategies in neuroendocrine neoplasms (NENs). Nevertheless, its role in certain tumor sites remains unclear. This study sought to elucidate the efficacy and safety of [Lu-177]Lu-DOTATATE in NENs with dif...

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Autores: Mitjavila, M. (Mercedes)|||/items/38689113-ae59-4d16-8d48-ab1973987ad2, Jiménez-Fonseca, P. (Paula)|||/items/b4a18f79-34f0-4736-8966-255e938b871a, Belló, P. (Pilar)|||/items/f870b89d-5e38-4c68-893d-c08ba71c67a0, Pubul, V. (Virginia)|||/items/a2690265-bed0-4ca8-8a7d-ad4b1587e939, Percovich, J.C. (Juan Carlos)|||/items/53638921-32a6-4d95-ad51-f546c990a590, García-Burillo, A. (Amparo)|||/items/8a1d740f-8c05-430e-828e-922eddaba6a1, Hernando, J. (Jorge)|||/items/e208dfe6-8d5b-4b1d-ae82-09b189b90ad5, Arbizu, J. (Javier)|||/items/41665d76-74c1-4652-acb9-a98cba4ddd0b, Rodeño, E. (Emilia)|||/items/9602d771-33c2-494e-9f8e-a08249134525, Estorch, M. (Montserrat)|||/items/18360a59-d283-405a-9a4e-7e45928353cc, Llana, B. (Belén)|||/items/3fe0e510-306c-46d9-9074-f4e7a3b328e5, Castellón, M. (Maribel)|||/items/92546d3c-5cc8-49ab-aa22-519ec9a13a4b, García-Canamaque, L. (Lina)|||/items/ae2d2888-f87b-45cb-87e0-2945561407da, Gajate, P. (Pablo)|||/items/f452bc8c-3bb6-46ec-b249-41f4b596ee3c, Riesco, M.C. (María del Carmen)|||/items/54433ae6-3e37-4236-98b8-d4e2010e2427, Miguel, M. B. (María Begoña)|||/items/60dcc6af-c0ff-4633-a3be-c77fdfc16850, Balaguer-Muñoz, D. (David)|||/items/655f893d-a7e5-45ad-8a06-f1c431b07d14, Custodio, A. (Ana)|||/items/48122708-d401-4eab-8a9c-06a55ceaa644, Cano, J. M. (Juana María)|||/items/3f58d339-5190-47e2-ac69-3a6023ab0401, Repetto, A. (Alexandra)|||/items/f42991d9-9e4a-4a61-98d2-ba38dbf1e3ad, García-Alonso, P. (Pilar)|||/items/6a9f40d2-7f28-455d-bb7c-8c56f7348b02, Muros, M. A. (María Angustias)|||/items/ec942827-5296-4586-a907-3e37f5f9041a, Vercher-Conejero, J. L. (José Luis)|||/items/7abed60e-5b5a-4595-8edf-524a98d03258, Carmona-Bayonas, A. (Alberto)|||/items/eb36b079-361e-478f-9dde-dea0d62109a2
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/67265
Acceso en línea:https://hdl.handle.net/10171/67265
Access Level:acceso abierto
Palabra clave:[Lu-177]Lu-DOTATATE
Lutathera
Lung
Neuroendocrine tumor
PRRT
Radionuclide therapy,RECEPTOR RADIONUCLIDE THERAPY
CONSENSUS GUIDELINES
TUMORS
LU-177-DOTATATE
LU-177-OCTREOTATE
CARCINOIDS
ANALOG
TRIAL
Radionuclide therapy
[177Lu]Lu-DOTATATE.
Descripción
Sumario:BackgroundPeptide receptor radionuclide therapy (PRRT) is one of the most promising therapeutic strategies in neuroendocrine neoplasms (NENs). Nevertheless, its role in certain tumor sites remains unclear. This study sought to elucidate the efficacy and safety of [Lu-177]Lu-DOTATATE in NENs with different locations and evaluate the effect of the tumor origin, bearing in mind other prognostic variables. Advanced NENs overexpressing somatostatin receptors (SSTRs) on functional imaging, of any grade or location, treated at 24 centers were enrolled. The protocol consisted of four cycles of Lu-177-DOTATATE 7.4 GBq iv every 8 weeks (NCT04949282).ResultsThe sample comprised 522 subjects with pancreatic (35%), midgut (28%), bronchopulmonary (11%), pheochromocytoma/ paraganglioma (PPGL) (6%), other gastroenteropancreatic (GEP) (11%), and other non-gastroenteropancreatic (NGEP) (9%) NENs. The best RECIST 1.1 responses were complete response, 0.7%; partial response, 33.2%; stable disease, 52.1%; and tumor progression, 14%, with activity conditioned by the tumor subtype, but with benefit in all strata. Median progression-free survival (PFS) was 31.3 months (95% CI, 25.7-not reached [NR]) in midgut, 30.6 months (14.4-NR) in PPGL, 24.3 months (18.0-NR) in other GEP, 20.5 months (11.8-NR) in other NGEP, 19.8 months (16.8-28.1) in pancreatic, and 17.6 months (14.4-33.1) in bronchopulmonary NENs. [Lu-177]Lu-DOTATATE exhibited scant severe toxicity.ConclusionThis study confirms the efficacy and safety of [Lu-177]Lu-DOTATATE in a wide range of SSTR-expressing NENs, regardless of location, with clinical benefit and superimposable survival outcomes between pNENs and other GEP and NGEP tumor subtypes different from midgut NENs.

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