Individualised 177Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry

Anna Sundlöv, Katarina Sjögreen-Gleisner, Johanna Svensson, Michael Ljungberg, Tomas G Olsson, Peter Bernhardt, Jan Tennvall

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87 Citations (SciVal)

Abstract

Purpose: To present data from an interim analysis of a Phase II trial designed to determine the feasibility, safety, and efficacy of individualising treatment based on renal dosimetry, by giving as many cycles as possible within a maximum renal biologically effective dose (BED). Method: Treatment was given with repeated cycles of 7.4 GBq 177Lu-DOTATATE at 8-12-week intervals. Detailed dosimetry was performed in all patients after each cycle using a hybrid method (SPECT + planar imaging). All patients received treatment up to a renal BED of 27 ± 2 Gy (α/β = 2.6 Gy) (Step 1). Selected patients were offered further treatment up to a renal BED of 40 ± 2 Gy (Step 2). Renal function was followed by estimation and measurement of the glomerular filtration rate (GFR). Results: Fifty-one patients were included in the present analysis. Among the patients who received treatment as planned, the median number of cycles in Step 1 was 5 (range 3-7), and for those who completed Step 2 it was 7 (range 5-8); 73% were able to receive >4 cycles. Although GFR decreased in most patients after the completion of treatment, no grade 3-4 toxicity was observed. Patients with a reduced baseline GFR seemed to have an increased risk of GFR decline. Five patients received treatment in Step 2, none of whom exhibited a significant reduction in renal function. Conclusions: Individualising PRRT using renal dosimetry seems feasible and safe and leads to an increased number of cycles in the majority of patients. The trial will continue as planned.

Original languageEnglish
Pages (from-to)1480-1489
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume44
Issue number9
Early online date2017 Mar 22
DOIs
Publication statusPublished - 2017

Subject classification (UKÄ)

  • Cancer and Oncology
  • Radiology, Nuclear Medicine and Medical Imaging
  • Other Physics Topics

Keywords

  • Lu-DOTATATE
  • Dosimetry
  • Neuroendocrine
  • PRRT
  • Renal function

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