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Yttrium-90 DOTATOC therapy in GEP-NET and other SST2 expressing tumors: a selected review

Annals of Nuclear Medicine volume 25, pages 75–85 (2011)Cite this article

Abstract

Treatment of somatostatin receptor-positive tumors with radiolabeled somatostatin analog is a promising option. Several phase I and phase II studies done at a few centers around the world reported encouraging results with [90Y-DOTA-Tyr3]-octreotide (DOTATOC) and/or [177Lu-DOTA-Tyr3-Thr8]-octreotate (DOTATATE). The current article is a selective review of patients who were treated mainly with 90Y-DOTATOC after failure with conventional therapy. The aim is to provide an updated comprehensive evaluation of the overall effectiveness of 90Y-DOTATOC therapy in patients with somatostatin-positive tumors. Review of several studies revealed an objective response rate ranging from 20 to 28% for all neuroendocrine tumors (NET)s. For gastroenteropancreatic-NET (GEP-NET), the response rate was found to be consistently better in the range 28–38%. Overall, the cumulative response rate was found to be 24%. An important issue in peptide receptor radionuclide therapy (PRRT) is the dose–response relationship and finding the correct dose of 90Y-DOTATOC that will achieve an optimum tumor kill. Nephrotoxicity was common but could be minimized by taking adequate renal protective measures. In conclusion, PRRT remains a good option in patients with inoperable and/or metastatic NETs particularly of GEP origin. Over a decade of experience with 90Y-DOTATOC proves that it is still an effective tool for the treatment of large infiltrative NETs with achievement of objective radiological responses in nearly a quarter and disease stabilization in more than half the patients studied so far.

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Authors and Affiliations

  1. Institute of Nuclear Medicine and Ultrasound, BSM Medical University Campus, Shahbagh, Dhaka, Bangladesh

    Lutfun Nisa

  2. U.O. Medicina Nucleare, Spedali Civili, Brescia, Italy

    Giordano Savelli & Raffaele Giubbini

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  1. Lutfun Nisa
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  2. Giordano Savelli
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Correspondence to Lutfun Nisa.

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Nisa, L., Savelli, G. & Giubbini, R. Yttrium-90 DOTATOC therapy in GEP-NET and other SST2 expressing tumors: a selected review. Ann Nucl Med 25, 75–85 (2011). https://doi.org/10.1007/s12149-010-0444-0

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  • DOI: https://doi.org/10.1007/s12149-010-0444-0

Keywords

  • 90Y-DOTATOC
  • Peptide receptor radionuclide therapy
  • Neuroendocrine tumors
  • Somatostatin analog
  • Gastroenteropancreatic-NET