Article Figures & Data
Figures
- FIGURE 1.
177Lu-DOTA-JR11 planar scans (A) and isodose curves (B) of patient 2 after injection of 1,065 MBq of 177Lu-DOTA-JR11 and corresponding 177Lu-DOTATATE planar scans (C) and isodose curves (D) after injection of 1,115 MBq of 177Lu-DOTATATE. Planar scans (A and C) show results 24 and 72 h after injection of 177Lu-DOTA-JR11 and 177Lu-DOTATATE.
- FIGURE 2.
177Lu-DOTA-JR11 planar scans (A) and isodose curves (B) of patient 3 after injection of 850 MBq of 177Lu-DOTA-JR11 and corresponding 177Lu-DOTATATE planar scans (C) and isodose curves (D) after injection of 990 MBq of 177Lu-DOTATATE. Planar scans (A and C) show results 24 and 72 h after injection of 177Lu-DOTA-JR11 and 177Lu-DOTATATE.
- FIGURE 3.
68Ga-DOTATATE PET images of patient 2 before (A) and 3 mo after (B) treatment with 15.2 GBq of 177Lu-DOTA-JR11 and 68Ga-DOTATATE PET images of patient 3 before (C) and 12 mo after (D) treatment with 5.9 GBq of 177Lu-DOTA-JR11. Three-month follow-up scan of patient 2 (B) shows decreased uptake by metastatic liver and bone disease and by primary tumor in right lung (arrow). Twelve-month follow-up scan of patient 3 (D) shows decreased uptake by metastatic liver disease.
Tables
- TABLE 1
Characteristics of Patients with Neuroendocrine Tumors and Chronic Kidney Insufficiency
Characteristic Patient 1 Patient 2 Patient 3 Patient 4 Age (y) 77 74 44 74 Sex F M F F Diagnosis Neuroendocrine carcinoma (bladder) Neuroendocrine tumor (lung) Neuroendocrine tumor (ileum) Neuroendocrine tumor (ileum) Tumor grade G3 G1 G2 G2 First diagnosed 5 mo ago 3 y ago 5 y ago 11 mo ago Pretreatment evaluation ECOG performance status 2 0 1 0 Remission status* PD PD PD PD Chronic kidney disease† Grade 3 Grade 3 Grade 2 Grade 3 Three-mo follow-up ECOG performance status 2 0 0 0 Remission status* Mixed response PR SD PR Chronic kidney disease† Grade 3 Grade 3 Grade 2 Grade 3 Adverse events‡ Anemia (reversible) Grade 2 Grade 1 Grade 2 Grade 2 Leukopenia (reversible) Grade 2 Grade 1 Grade 2 Grade 0 Thrombocytopenia (reversible) Grade 0 Grade 3 Grade 0 Grade 0 Maximum follow-up (mo) 15 12 13 12 Remission status† PD PR SD PR ↵* Response was assessed with CT according to the Response Evaluation Criteria in Solid Tumors, version 1.1.
↵† Chronic kidney disease was graded according to the guidelines of the National Kidney Foundation.
↵‡ Adverse events were graded according to the Common Terminology Criteria for Adverse Events, version 4.0, of the National Cancer Institute.
ECOG = Eastern Cooperative Oncology Group; PD = progressive disease; PR = partial response; SD = stable disease.
Pretreatment evaluation 177Lu-DOTATATE 177Lu-DOTA-JR11 Treatment Three-mo follow-up CT Tumor no. Tumor site CT tumor volume (cm3) Tumor dose (Gy/GBq) T/K ratio T/BM ratio Tumor dose (Gy/GBq) T/K ratio T/BM ratio 177Lu-DOTA-JR11 total tumor dose* (Gy) Tumor volume (cm3) Tumor reduction (%) Patient 1 1 LN 23 2.0 1.6 22 7.4 3.3 56 59 13 45 2 LN 1.7 1.2 0.9 13 7.0 3.1 53 31 1.5 13 3 LN 22 1.4 1.1 15 5.7 2.5 44 47 5.9 73 4 LN 0.4 1.1 0.9 12 5.9 2.6 45 23 0.1 80 5 LN 0.9 2.0 1.6 22 7.4 3.3 56 39 0 100 Patient 2 6 Liver 59 13 9.0 133 22 15 223 374 5.4 91 7 Liver 66 6.3 4.4 65 29 20 294 487 29 56 8 Lung 26 5.6 3.9 57 16 11 162 283 6.8 73 Patient 3 9 LN 9.3 0.5 0.6 7.9 5.3 3.7 57 130 5.9 37 10 Liver 26 2.7 3.6 43 5.9 4.1 63 33 25 5 11 Liver 7.7 2.2 3.0 35 4.8 3.3 52 37 5.8 24 Patient 4 12 Liver 0.4 4.6 3.2 68 20 9.3 245 302 0 100 13 Liver 2.2 1.5 1.0 22 4.2 1.9 51 39 0.4 82 Median 9.3 2.0 1.6 22 7.0 3.3 56 47 5.8 73 Interquartile range 1.7–26 1.2–4.6 1.0–3.6 15–57 5.7–16 3.1–9.3 52–162 37–283 0.4–6.8 37–82 ↵* Total treatment activities were 6.1 GBq for patient 1 (2 treatment cycles), 15.2 GBq for patient 2 (3 treatment cycles), 5.9 GBq for patient 3 (2 treatment cycles), and 13.7 GBq for patient 4 (3 treatment cycles).
T/K = tumor-to-kidney; T/BM = tumor–to–bone marrow; LN = lymph node.
Tumor volumes were calculated assuming ellipsoid shape. Respective tumor diameters were obtained from 3-dimensional CT reconstructions. Tumor doses were calculated using 3-dimensional voxel-based approach and are given as mean absorbed doses.
- TABLE 3
Comparison of 177Lu-DOTATATE and 177Lu-DOTA-JR11 Organ and Effective Doses of 4 Patients with Neuroendocrine Tumors or Carcinomas
Organ 177Lu-DOTATATE 177Lu-DOTA-JR11 Adrenals 0.072 ± 0.019 0.11 ± 0.024 Brain 0.061 ± 0.018 0.10 ± 0.020 Breasts 0.061 ± 0.018 0.10 ± 0.020 Gallbladder wall 0.070 ± 0.020 0.11 ± 0.023 GI (LLI wall) 0.065 ± 0.019 0.11 ± 0.021 GI (small intestine) 0.066 ± 0.019 0.11 ± 0.021 GI (stomach wall) 0.069 ± 0.020 0.11 ± 0.024 GI (ULI wall) 0.066 ± 0.019 0.11 ± 0.021 Heart wall 0.065 ± 0.019 0.11 ± 0.021 Kidneys* 1.2 ± 0.35 1.8 ± 0.44 Liver 0.25 ± 0.096 0.33 ± 0.16 Lungs 0.065 ± 0.019 0.11 ± 0.021 Muscle 0.063 ± 0.019 0.10 ± 0.020 Ovaries 0.056 ± 0.009 0.10 ± 0.025 Pancreas 0.075 ± 0.021 0.12 ± 0.027 Red marrow 0.079 ± 0.018 0.10 ± 0.021 Osteogenic cells 0.22 ± 0.053 0.35 ± 0.068 Skin 0.060 ± 0.018 0.10 ± 0.019 Spleen 2.5 ± 1.5 3.0 ± 2.3 Thymus 0.063 ± 0.019 0.10 ± 0.020 Thyroid 0.062 ± 0.019 0.10 ± 0.020 Urinary bladder wall 0.26 ± 0.13 0.37 ± 0.21 Uterus 0.066 ± 0.019 0.11 ± 0.021 Total body 0.083 ± 0.021 0.13 ± 0.031 Effective dose (Sv/GBq) 0.15 ± 0.046 0.20 ± 0.075 ↵* Only kidney doses were calculated using 3-dimensional voxel-based technique. Range of kidney doses was 0.71–1.45 Gy/GBq for 177Lu-DOTATATE and 1.44–2.27 Gy/GBq for 177Lu-DOTA-JR11.
GI = gastrointestinal; LLI = lower large intestine; ULI = upper large intestine.
Data are mean absorbed dose ± SD in Gy/GBq.
Jump to section
Related Articles
Cited By...
- Side-by-Side Comparison of the In Vivo Performance of [212Pb]Pb-DOTAMTATE and Other SSTR2-Targeting Compounds
- Limitations of the radiotheranostic concept in neuroendocrine tumors due to lineage-dependent somatostatin receptor expression on hematopoietic stem and progenitor cells
- Radiolabeled Somatostatin Receptor Antagonist Versus Agonist for Peptide Receptor Radionuclide Therapy in Patients with Therapy-Resistant Meningioma: PROMENADE Phase 0 Study
- Somatostatin Receptor Antagonists as a Theranostic Option in Iodine-Refractory Thyroid Carcinoma
- 68Ga-SSO-120 PET for Initial Staging of Small Cell Lung Cancer Patients: A Single-Center Retrospective Study
- Somatostatin Receptor Antagonists as a Theranostic Option in Iodine-Refractory Thyroid Carcinoma
- The Emergence of Somatostatin Antagonist-Based Theranostics: Paving the Road Toward Another Success?
- First-in-Humans Study of the SSTR Antagonist 177Lu-DOTA-LM3 for Peptide Receptor Radionuclide Therapy in Patients with Metastatic Neuroendocrine Neoplasms: Dosimetry, Safety, and Efficacy
- Treatment of advanced gastroenteropancreatic neuroendocrine neoplasia, are we on the way to personalised medicine?
- 177Lu-DOTA-EB-TATE, a Radiolabeled Analogue of Somatostatin Receptor Type 2, for the Imaging and Treatment of Thyroid Cancer
- Multimodal Imaging of 2-Cycle PRRT with 177Lu-DOTA-JR11 and 177Lu-DOTATOC in an Orthotopic Neuroendocrine Xenograft Tumor Mouse Model
- Head-to-Head Comparison of 68Ga-DOTA-JR11 and 68Ga-DOTATATE PET/CT in Patients with Metastatic, Well-Differentiated Neuroendocrine Tumors: A Prospective Study
- Cholecystokinin 2 Receptor Agonist 177Lu-PP-F11N for Radionuclide Therapy of Medullary Thyroid Carcinoma: Results of the Lumed Phase 0a Study
- NANETS/SNMMI Consensus Statement on Patient Selection and Appropriate Use of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy
- Phase I Trial of Well-Differentiated Neuroendocrine Tumors (NETs) with Radiolabeled Somatostatin Antagonist 177Lu-Satoreotide Tetraxetan
- Future of Theranostics: An Outlook on Precision Oncology in Nuclear Medicine
- Medical Management of Gastroenteropancreatic Neuroendocrine Tumors: Current Strategies and Future Advances
- New Developments in Peptide Receptor Radionuclide Therapy
- The Relevance of Dosimetry in Precision Medicine
- Somatostatin Receptor Imaging of Neuroendocrine Tumors: From Agonists to Antagonists
- Sensitivity Comparison of 68Ga-OPS202 and 68Ga-DOTATOC PET/CT in Patients with Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Phase II Imaging Study
- 177Lu-3BP-227 for Neurotensin Receptor 1-Targeted Therapy of Metastatic Pancreatic Adenocarcinoma: First Clinical Results
- Somatostatin Antagonists for Radioligand Therapy of Nonendocrine Tumors
- Repeated 177Lu-Labeled PSMA-617 Radioligand Therapy Using Treatment Activities of Up to 9.3 GBq
- Advantages and Limits of Targeted Radionuclide Therapy with Somatostatin Antagonists
- SSTR-Mediated Imaging in Breast Cancer: Is There a Role for Radiolabeled Somatostatin Receptor Antagonists?
- Clinical History of the Theranostic Radionuclide Approach to Neuroendocrine Tumors and Other Types of Cancer: Historical Review Based on an Interview of Eric P. Krenning by Rachel Levine
- Somatostatin Receptor 2-Targeting Compounds
- Biodistribution, Pharmacokinetics, and Dosimetry of 177Lu-, 90Y-, and 111In-Labeled Somatostatin Receptor Antagonist OPS201 in Comparison to the Agonist 177Lu-DOTATATE: The Mass Effect
- Glu-Ureido-Based Inhibitors of Prostate-Specific Membrane Antigen: Lessons Learned During the Development of a Novel Class of Low-Molecular-Weight Theranostic Radiotracers
- Somatostatin Receptor Antagonists for Imaging and Therapy
- Clinical Trial with Sodium 99mTc-Pertechnetate Produced by a Medium-Energy Cyclotron: Biodistribution and Safety Assessment in Patients with Abnormal Thyroid Function
- Highly Increased 125I-JR11 Antagonist Binding In Vitro Reveals Novel Indications for sst2 Targeting in Human Cancers
- Citius, Altius, Fortius: An Olympian Dream for Theranostics
- Comparison of the Therapeutic Response to Treatment with a 177Lu-Labeled Somatostatin Receptor Agonist and Antagonist in Preclinical Models
- Radiopeptides for Imaging and Therapy: A Radiant Future
- Radioisotopic Purity of Sodium Pertechnetate 99mTc Produced with a Medium-Energy Cyclotron: Implications for Internal Radiation Dose, Image Quality, and Release Specifications
- Carcinoid and Neuroendocrine Tumors: Building on Success
- In Vitro and In Vivo Application of Radiolabeled Gastrin-Releasing Peptide Receptor Ligands in Breast Cancer
- Triple-Peptide Receptor Targeting In Vitro Allows Detection of All Tested Gut and Bronchial NETs
- Targeting Neuropeptide Receptors for Cancer Imaging and Therapy: Perspectives with Bombesin, Neurotensin, and Neuropeptide-Y Receptors