Peptide Receptor Radionuclide Therapy for Neuroendocrine Tumors in Germany: First Results of a Multi-institutional Cancer Registry
Peptide receptor radionuclide therapy is an effective treatment option for patients with well-differentiated somatostatin receptor-expressing neuroendocrine tumors. However, published data result mainly from retrospective monocentric studies. We initiated a multi-institutional, prospective, board-reviewed registry for patients treated with peptide receptor radionuclide therapy in Germany in 2009. In five centers, 297 patients were registered. Primary tumors were mainly derived from pancreas (117/297) and small intestine (80/297), whereas 56 were of unknown primary. Most tumors were well differentiated with median Ki67 proliferation rate of 5% (range 0.9–70%). Peptide receptor radionuclide therapy was performed using mainly yttrium-90 and/or lutetium-177 as radionuclides in 1–8 cycles. Mean overall survival was estimated at 213 months with follow-up between 1 and 230 months after initial diagnosis, and 87 months with follow-up between 1 and 92 months after start of peptide receptor radionuclide therapy. Median overall survival was not yet reached. Subgroup analysis demonstrated that best results were obtained in neuroendocrine tumors with proliferation rate below 20%. Our results indicate that peptide receptor radionuclide therapy is an effective treatment for well- and moderately differentiated neuroendocrine tumors irrespective of previous therapies and should be regarded as one of the primary treatment options for patients with somatostatin receptor-expressing neuroendocrine tumors.
KeywordsProliferation Rate Neuroendocrine Tumor Proliferation Index Peptide Receptor Radionuclide Therapy Previous Therapy
We are indebted to all patients who agreed to be registered. The registry of peptide receptor radionuclide therapy was founded in 2009 by U. Plöckinger and S. Schwartz-Fuchs with great enthusiasm. Data collection and analysis were performed by S. Skrobek-Engel and H. Franz of Lohmann and Birkner in Berlin, Germany. Supported by Covidien Inc., ITG, MDS Nordion, and Eckert and Ziegler Radiopharma GmbH.
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