Effectiveness and Safety of Retreatment with 177Lu-DOTATATE in Patients with Progressive Neuroendocrine Tumors: A Retrospective Real-World Study in the United States

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Download figure
Open in new tab
Download powerpoint
FIGURE 1.
PFS from start of initial treatment (A) and retreatment (B) with ¹⁷⁷Lu-DOTATATE. PFS was calculated postindex and postindex retreatment.
Download figure
Open in new tab
Download powerpoint
FIGURE 2.
OS from start of initial treatment (A) and retreatment with ¹⁷⁷Lu-DOTATATE. OS was calculated postindex and postindex retreatment.

TABLE 1.

Patient Characteristics at Initial Treatment and Retreatment with ¹⁷⁷Lu-DOTATATE

Characteristic	Initial treatment (n = 31)	Retreatment (n = 31)
Age (y)	59.8 ± 9.0	62.2 ± 8.9
Male	19 (61.3%)	19 (61.3%)
Race
White	29 (93.5%)	29 (93.5%)
Black	1 (3.2%)	1 (3.2%)
Asian	1 (3.2%)	1 (3.2%)
Weight
Median	79 kg (175 lb)	78 kg (172 lb)
Interquartile range	60–92 kg (132–203 lb)	64–93 kg (140–205 lb)
Primary tumor type
Gastrointestinal	12 (38.7%)	12 (38.7%)
Pancreatic	16 (51.6%)	16 (51.6%)
Lung	2 (6.5%)	2 (6.5%)
Adrenal	1 (3.2%)	1 (3.2%)
Time since primary diagnosis (y)	6.2 ± 5.3	8.5 ± 5.8
Number of metastatic sites	3.1 ± 1.4	3.5 ± 1.3
Location of metastatic sites
Bone	18 (58.1%)	26 (83.9%)
Liver	30 (96.8%)	31 (100%)
Lung	5 (16.1%)	6 (19.4%)
Spleen	5 (16.1%)	6 (19.4%)
Mesentery	8 (25.8%)	9 (29.0%)
Distant lymph nodes	18 (58.1%)	19 (61.3%)
Other	8 (25.8%)	10 (32.2%)
Laboratory values
WBC (10³/μL)	5.7 ± 1.7	6.0 ± 2.8
Hemoglobin (g/dL)	12.6 ± 1.4	11.3 ± 1.5
ANC (cells/μL)	3,914 ± 1,447	4,306 ± 2,388
Platelet count (10³/μL)	236.1 ± 177.2	205.2 ± 117.9
Lymphocyte count (cells/μL)	1,060 ± 495.1	929.7 ± 377.3
ALP (U/L)	175.7 ± 128.8	279.9 ± 227.5
ALT (U/L)	49.3 ± 52.8	36.0 ± 23.1
AST (U/L)	49.6 ± 64.2	35.7 ± 21.4
Creatinine (mg/dL)	1.0 ± 0.4	1.0 ± 0.2
eGFR (mL/min/1.73 m²)	80.1 ± 18.5	77.6 ± 19.0

WBC = white blood cell count; ANC = absolute neutrophil count; ALP = alkaline phosphatase; ALT = alanine aminotransferase; AST = aspartate aminotransferase; eGFR = estimated glomerular filtration rate.
Qualitative data are number and percentage; quantitative data are mean ± SD, except for weight. Laboratory values were based on measurements on or up to 2 wk before date of first cycle in each of initial treatment and retreatment phases.

TABLE 2.

¹⁷⁷Lu-DOTATATE Treatment Distribution by Treatment Phase

	Treatment phase
Parameter	Initial treatment (n = 31)	Retreatment (n = 31)	Additional retreatment (n = 2)
Number of cycles received by treatment phase
1	0	6 (19.4%)	1 (50.0%)
2	0	24 (77.4%)	1 (50.0%)
3	2 (6.5%)	1 (3.2%)	0
4	29 (93.5%)	0	0
Administered ¹⁷⁷Lu-DOTATATE by treatment phase (GBq)	28.8 ± 2.4	13.1 ± 3.6	10.6 ± 4.7
Cumulative number of cycles	—	5.8 ± 0.4	7.5 ± 0.7
Cumulative administered ¹⁷⁷Lu-DOTATATE (GBq)	—	41.9 ± 4.4	55.3 ± 5.3

TABLE 4.

Comparison of Hematologic Parameters at Start of Each Treatment Phase

↵* Measured on or up to 2 wk before date of first cycle in each treatment phase.
↵† Measured from 2 wk before 8 wk after date of last cycle in each treatment phase.
↵‡ Includes only patients who had measurement at both baseline and end of treatment.
WBC = white blood cell count; ANC = absolute neutrophil count.
Laboratory values are mean ± SD.

TABLE 5.

AEs During Treatment with ¹⁷⁷Lu-DOTATATE

↵* Key hematologic AEs included any leukopenia, anemia, neutropenia, and thrombocytopenia.
ALP = alkaline phosphatase; ALT = alanine aminotransferase; AST = aspartate aminotransferase; eGFR = estimated glomerular filtration rate.
AEs were measured from the date of the first cycle to 8 wk after the last cycle for each treatment phase.