Clinical and Translational Imaging

, Volume 6, Issue 2, pp 101–111 | Cite as

Peptide receptor radionuclide therapy for neuroendocrine tumours

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Part of the following topical collections:
  1. Radionuclide therapy

Abstract

Background

Neuroendocrine tumours (NETs) are a heterogeneous group of tumours that arise in different tissues and organs and have an endocrine and neurological interface that differentiates them into a stand-alone entity. One of their interesting and unique criteria is the overexpression of somatostatin receptors (SSRs) on their cell membrane, which has allowed for specific diagnostic imaging techniques and targeted therapy like peptide receptor radionuclide therapy (PRRT).

Objective

The aim of this study is to provide a literature review summarizing the latest available studies concerning the use of PRRT in treatment of neuroendocrine tumours including patient selection, the choice of PRPP, efficacy, side effects, and complications.

Methods

A comprehensive search strategy was used based on SCOPUS and PubMed databases. We considered all studies published in English evaluating the use of PRRT (177Lu-Dotatate and 90Y-Dotatate) in treatment of NETs and its effectiveness and side effects and complications.

Results

PRRT was found to be effective as monotherapy or in combination with other therapies. 90Yttrium may be more appropriate for larger tumour lesions, while 177Lutetium is more appropriately used for smaller ones. A combination therapy with 90Yttrium and 177Lutetium has been suggested for variable sized lesions. Mild acute side effects were reported more in 177Lutetium, while sub-acute and long-term side effects are more with 90Yttrium. Heamatotoxicity is usually mild and reversible and only < 15% may progress into severe toxicity. Renal toxicity was greatly reduced to < 3% by kidney protective measures.

Conclusions

PRRT is well-tolerated and effective treatment modality for non-operable and/or metastatic neuroendocrine tumours. Side effects are usually mild and reversible. More work needs to be done regarding standardization of dosing, timing, and patient selection criteria and ways of follow-up to obtain the maximum potential benefit.

Keywords

PRRT Neuroendocrine tumours 177Lu-Dotatate 90Y-Dotatate SSTR 1–5 68Ga-Dotatate PET/CT 

Notes

Author contributions

SY: content planning, literature search and review, manuscript writing, and editing. SA: literature search and review, manuscript writing, and editing. AA-N: content planning, literature search and review, manuscript writing, and editing.

Compliance with ethical standards

Conflict of interest

The authors, Siraj Yusuf, Shahad Alsadik, and Adil AL-Nahhas, have no conflict of interest to declare.

Ethical standards

This article does not contain any studies with human or animal subjects performed by the any of the authors.

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Copyright information

© Italian Association of Nuclear Medicine and Molecular Imaging 2018

Authors and Affiliations

  1. 1.Department of Nuclear Medicine, Hammersmith HospitalImperial College NHS TrustLondonUK

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