Benefits of 90Y DOTA TATE therapy in patients with progressive metastatic neuroendocrine tumours

Abstract

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Objectives: To evaluate the clinical and radiological effectiveness of 90Y DOTA TATE in patients with extensive progressive somatostatin receptor positive neuroendocrine tumors-NETs.

Methods: The study was approved by the ethics committee; 56 patients, mean age 52yrs, histological proven extensive non-resectable and progressive neuroendocrine carcinomas. I.v. injection 90Y DOTA-TATE performed at 7-9 weeks, mean activity per administration of 3,8GBq. The objective tumor response was according to RECIST: complete regression (CR), partial response (PR), stable disease (SD), or disease progression (DP). Kaplan-Meier analysis was used to estimate overall survivals (OS) and progression free survival (PFS).

Results: Therapy efficacy was evaluated in 54 subjects; 6M after final treatment clinical response was seen in 39 pts (72%), DS 10 pts (19%) and DP 5 pts (9%). RECIST was available in 50 pts, PR-8 (16%), DS-40 pts (80%) and DP-2 subjects (4%). In those subjects with initial clinical PR we noted 6 deaths (15%), during 30 months of follow-up. In DS group 2 deaths (20%) and group with DP (7 pts) all patients died between 6-12months, including 2 subjects who died during therapy. Patients with clinical PR median PFS was 16 months, while the median OS was 20 months. In subjects with clinical DP the median PFS was 6 months, and median OS 10 months.

Conclusions: Therapy with 90Y-DOTA TATE is effective in case of patients with extensive progressive NET, including PFS and OS, comparable to 90Y DOTA TOC. Intravenous administration of standard doses of 90Y DOTA TATE results in a low risk of myelotoxicity. However due to ongoing risk of renal toxicity careful monitoring of the renal system is recommended.

Research Support: Grant N51800131/0040