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Nuclear Medicine Approaches to Treatment of Neuroendocrine Tumors

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Management of Pancreatic Neuroendocrine Tumors

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Abstract

Neuroendocrine tumors (NETs) often overexpress somatostatin receptors (SSTRs) on the tumor cell surface. SSTR targeting peptide ligands labeled with 68Ga and 90Y/177Lu may serve as “theranostic pairs” for diagnosis and treatment of NETs.

Peptide receptor radionuclide therapy (PRRT) for gastrointestinal neuroendocrine tumors (NETs) is widely used in European clinics. Patients in whom SSTR expression is demonstrated using 68Ga-DOTATATE PET and who are progressing under “cold” octreotide monotherapy are offered PRRT with 177Lu-/90Y-DOTATOC/DOTATATE.

PRRT is regarded as a safe therapy: acute side effects are nausea and vomiting but also life-threatening hyperkalemia. Regarding delayed side effects, myelosuppression and serious renal impairment were reported in few cases. For the latter, amino acid solutions should be administered during therapy in order to reduce renal absorbed dose. In addition to PRRT, locoregional therapies such as selective internal radiation therapy (SIRT) can be performed in case of liver-dominant metastasis in addition to PRRT.

Currently ongoing trials investigate whether individual dosimetry-derived personalized “high-dose” approaches allow for patient-tailored treatment.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, Würzburg, 97080, Germany

    Ken Herrmann, Rudolf A. Werner & Christina Blümel

  2. Department of Molecular and Medical Pharmacology, UCLA Medical Center, Medical Plaza 200, Suite B114-61, Los Angeles, CA, 90095, USA

    Martin S. Allen-Auerbach

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  1. Ken Herrmann
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  2. Rudolf A. Werner
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  4. Martin S. Allen-Auerbach
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Correspondence to Martin S. Allen-Auerbach .

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Editors and Affiliations

  1. VA Greater Los Angeles Healthcare System, David Geffen School of Medicine at UCLA VA Greater Los Angeles Healthcare System, Los Angeles, California, USA

    Joseph R. Pisegna

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Herrmann, K., Werner, R.A., Blümel, C., Allen-Auerbach, M.S. (2015). Nuclear Medicine Approaches to Treatment of Neuroendocrine Tumors. In: Pisegna, J. (eds) Management of Pancreatic Neuroendocrine Tumors. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1798-3_11

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  • DOI: https://doi.org/10.1007/978-1-4939-1798-3_11

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