Article Figures & Data
Figures
- FIGURE 1.
Planar images (anterior and posterior views at 24 h) showing typical biodistribution of 177Lu-DOTATATE. Linear intensity gray scale bars illustrate contrast enhancement, where bottom (absolute black) value represents specified percentage of original image’s maximum intensity. (A) Patient with low tumor burden. (B) Patient with multiorgan involvement. (C) Patient with predominately liver-only metastatic disease with high liver tumor burden.
- FIGURE 2.
Time–activity curves in the kidneys after 1 administration of 177Lu-DOTATATE. Red dashed curve intersects median value of each time point. IA = injected activity; Pt = patient.
- FIGURE 3.
Bone marrow toxicity relative to cumulative absorbed dose. Point values are worst Common Terminology Criteria for Adverse Events version 4.03 score for bone marrow–related toxicity at any time during (○) or after (*) treatment at patient’s corresponding cumulative bone marrow absorbed dose. (A) Hemoglobin. (B) White blood cells. (C) Neutrophils. (D) Lymphocytes. (E) Platelets.
- FIGURE 4.
Tumor dosimetry. (A) Time–activity curves in target lesions after 1 administration of 7.4 GBq represented as percentage of injected activity (%IA) against time. (B) Absorbed dose after 1 administration of 7.4 GBq (top panel) and mass at time of dosimetry measurement (bottom panel) of all tumors evaluated (n = 65) in substudy patients with dosimetry (n = 17); arrows indicate values exceeding 200. (C) Frequency distribution of all tumors with dosimetry (n = 65) according to actual cumulative absorbed dose values.
- FIGURE 5.
Best percentage tumor size change from baseline (assessed by area) at any time after treatment relative to cumulative absorbed dose of 177Lu-DOTATATE. Lesion size (mm2) corresponds to size at baseline (or first measurement).
Tables
Characteristic Evaluable (n = 20) Sex Female 9 (45) Male 11 (55) Age (y) 57.4 (11.2) Weight (kg) 79.2 (22.2) Body surface area (m2) 1.90 (0.28) Cumulative injected activity (GBq) 26.2 (6.6) Metastases Liver 16 (80) Bone 4 (20) Number of 177Lu-DOTATATE administrations 1 1 (5) 2 1 (5) 3 3 (15) 4 15 (75) Timing of dosimetry Cycle 1 8 (40) Cycle 2 6 (30) Cycle 3 6 (30) Median duration of follow-up (mo) (n = 19)* 62.9 (range, 9–89) Number of target lesions (n = 17)† 65 Target lesion location Liver 33/65 (51) Lymph node 16/65 (25) Mesenteric 5/65 (8) Paraaortic 5/65 (8) Other‡ 6/65 (9) Peritoneum 3/65 (5) Abdomen/bowel 3/65 (5) Mesenteric mass 2/65 (3) Bone 2/65 (3) Mediastinal 2/65 (3) Other§ 4/65 (6) ↵* From the date of first 177Lu-DOTATATE administration (1 patient who discontinued immediately after first administration is excluded from the calculation).
↵† Three patients were nonevaluable.
↵‡ One each of paracardiac, retroperitoneal, inguinal, interportocaval, aortocaval, and paracaval.
↵§ One each in dorsomedial pleura, adrenal, paraspinal mass, and spleen.
Categoric variables are represented as number with percentage in parentheses, and continuous variables are represented as mean with SD in parentheses unless otherwise indicated.
- TABLE 2.
Predicted Cumulative Absorbed Doses to Normal Organs and Target Lesions Calculated Per Unit of Activity and for Four Planned Administrations of 7.4 GBq (29.6 GBq total) of 177Lu-DOTATATE (n = 20)
Absorbed dose per unit activity (Gy/GBq) Absorbed dose for four 7.4 GBq (29.6 GBq in total) (Gy) Organ Mean (SD) Median (range) Mean (SD) Median (range) Kidneys 0.65 (0.30) 0.68 (0.16–1.17) 19.4 (8.7) 19.3 (4.8–34.6) Liver* 0.30 (0.23) 0.33 (0.05–2.06) 8.9 (6.7) 6.8 (1.6–23.7) Red marrow from blood 0.04 (0.03) 0.03 (0.01–0.14) 1.0 (0.8) 0.7 (0.3–4.1) Spleen 0.85 (0.80) 0.62 (0.18–3.61) 25.1 (23.8) 18.2 (5.4–106.9) Urinary bladder wall 0.44 (0.18) 0.4 (0.2–0.8) 12.8 (5.3) 11.9 (4.5–22.6) Total body 0.05 (0.03) 0.05 (0.01–0.1) 1.6 (0.8) 1.6 (0.4–3.1) Tumor lesions† 7.6 (10.6) 4.5 (0.2–74.9) 224 (313) 134 (7–2,218)
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