Piscopo, Leandra (2024) Safety and efficacy of peptide receptor radionuclide therapy for gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs): a single center experience. [Tesi di dottorato]
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| Tipologia del documento: | Tesi di dottorato |
|---|---|
| Lingua: | English |
| Titolo: | Safety and efficacy of peptide receptor radionuclide therapy for gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs): a single center experience |
| Autori: | Autore Email Piscopo, Leandra Leandra.piscopo@gmail.com |
| Data: | 5 Marzo 2024 |
| Numero di pagine: | 28 |
| Istituzione: | Università degli Studi di Napoli Federico II |
| Dipartimento: | Scienze Biomediche Avanzate |
| Dottorato: | Scienze biomorfologiche e chirurgiche |
| Ciclo di dottorato: | 36 |
| Coordinatore del Corso di dottorato: | nome email Cuocolo, Alberto cuocolo@unina.it |
| Tutor: | nome email Klain, Michele [non definito] |
| Data: | 5 Marzo 2024 |
| Numero di pagine: | 28 |
| Parole chiave: | Gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs); peptide receptor radionuclide therapy (PRRT); theragnostic concept; positron emission tomography/computed tomography (PET/CT). |
| Settori scientifico-disciplinari del MIUR: | Area 06 - Scienze mediche > MED/36 - Diagnostica per immagini e radioterapia |
| Depositato il: | 15 Mar 2024 10:21 |
| Ultima modifica: | 13 Apr 2026 08:18 |
| URI: | http://www.fedoa.unina.it/id/eprint/15559 |
Abstract
Aim: We aimed to evaluate the results of our single center experience with 177 Lu-DOTATATE therapy at the University Federico II of Naples, in order to assess the safety and efficacy of peptide receptor radionuclide therapy (PRRT) in patients with progressive, advanced, well-differentiated G1 and G2 gastroenteropancreatic (GEP) neuroendocrine tumors (NETs). This approach emphasizes the theragnostic concept by using somatostatin receptors (SSTR) analogues that can be labeled with Gallium-68 (68Ga) for positron emission tomography/computed tomography (PET/CT) imaging, and in this case Lutetium-177 (177 Lu) for therapy. Materials and Methods: We described the inclusion and exclusion criteria for treatment with 177 Lu-DOTATATE at our center and the methodology for patient selection by a multidisciplinary team. All subjects selected for PRRT were planned to have a course of four cycles each of 7–8 GBq of 177Lu-DOTATATE separated at eight weekly intervals over a 6-month period. According to European guidelines, we evaluated the renal, bone marrow toxicity and dosimetry for each patient. Results: From October 2020 to November 2023, we treated 21 G1/G2 GEP-NETs patients. A total of 17 (81%) patients were male, with a mean age of 65±9 years. The more prevalent location of GEP-NETs was small intestine (n=12). The mean adsorbed dose per administered activity for organ at risks (OARs) resulted 1.58 (1.34-1.90 Gy/GBq) for kidneys, 0.46 (0.15-0.85 Gy/GBq) for bladder, 2.76 (0.37-7.37 Gy/GBq) for liver, 1.20 (1.05-1.92 Gy/GBq) for spleen and 0.23 (0.14-0.38 Gy/GBq) for bone marrow, with a body background of 0.50 (0.18-1.11 Gy/GBq). When we considered the mean adsorbed dose per administered activity for the target lesions, it resulted 6.78 (0.55-13.38 Gy/GBq) for hepatic metastases and 1.52 (0.29-3.85 Gy/GBq) for lymph nodes. About the bone marrow toxicity there was a significant variation in both platelets and white blood cells counts among all time points (both p < 0.05), but at post-hoc analysis that disappeared 3 months after the end of the therapy. The response to therapy was evaluated according to RECIST criteria and at Kaplan-Meier analysis, the mean PFS in the overall population was 32.01 months (95% C.I. 18.89 – 49.01 months). Conclusions: Our data confirm that 177Lu-DOTATATE therapy is safe and effective in controlling the burden disease of G1/G2 GEP-NETs patients and emphasizes the importance of multidisciplinary approach to these patients.
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