TY - JOUR
T1 - Peptide receptor radionuclide therapy for patients with advanced pancreatic neuroendocrine tumors
AU - Ramage, John
AU - Naraev, Boris G.
AU - Halfdanarson, Thorvardur R.
PY - 2018/8
Y1 - 2018/8
N2 - 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is now approved for patients with advanced gastroenteropancreatic neuroendocrine tumors (NET), and it is therefore important to understand the efficacy and safety of PRRT in this patient population. PRRT efficacy and safety outcomes have frequently been summarized for patient populations with gastroenteropancreatic NET, but not specifically in patients with pancreatic NET (panNET). The pivotal phase 3 trial of 177Lu-DOTATATE PRRT in NET was restricted to patients with a midgut primary site. No phase 3 trial data on PRRT treatment outcomes are currently available for the panNET patient population. This review presents the available evidence for panNET treatment outcomes with PRRT and demonstrates that the available data favor PRRT as a modality for this NET primary site. However, several other therapies for advanced panNET are currently available, and the sequencing and combination of PRRT with these other therapies is set to become the big challenge for the future of panNET management. Patient, tumor, and logistical factors (tumor burden, expression of somatostatin receptors, availability of PRRT, patient preferences, and concerns over long-term toxicity) need to be taken into consideration when selecting therapy.
AB - 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is now approved for patients with advanced gastroenteropancreatic neuroendocrine tumors (NET), and it is therefore important to understand the efficacy and safety of PRRT in this patient population. PRRT efficacy and safety outcomes have frequently been summarized for patient populations with gastroenteropancreatic NET, but not specifically in patients with pancreatic NET (panNET). The pivotal phase 3 trial of 177Lu-DOTATATE PRRT in NET was restricted to patients with a midgut primary site. No phase 3 trial data on PRRT treatment outcomes are currently available for the panNET patient population. This review presents the available evidence for panNET treatment outcomes with PRRT and demonstrates that the available data favor PRRT as a modality for this NET primary site. However, several other therapies for advanced panNET are currently available, and the sequencing and combination of PRRT with these other therapies is set to become the big challenge for the future of panNET management. Patient, tumor, and logistical factors (tumor burden, expression of somatostatin receptors, availability of PRRT, patient preferences, and concerns over long-term toxicity) need to be taken into consideration when selecting therapy.
KW - Neuroendocrine tumors
KW - Pancreas
KW - Pancreatic
KW - Peptide receptor radionuclide therapy
UR - http://www.scopus.com/inward/record.url?scp=85055280029&partnerID=8YFLogxK
U2 - 10.1053/j.seminoncol.2018.08.004
DO - 10.1053/j.seminoncol.2018.08.004
M3 - Review article
C2 - 30539715
AN - SCOPUS:85055280029
SN - 0093-7754
VL - 45
SP - 236
EP - 248
JO - Seminars in Oncology
JF - Seminars in Oncology
IS - 4
ER -