PT  - JOURNAL ARTICLE
AU  - Gococo-Benore, Denise A.
AU  - Kuhlman, Justin
AU  - Parent, Ephraim E.
AU  - Sharma, Akash
AU  - Accurso, Joseph
AU  - Yang, Ming
AU  - Kendi, Ayse Tuba
AU  - Johnson, Geoff
AU  - Sonbol, Mohamad Bassam
AU  - Hobday, Timothy
AU  - Halfdanarson, Thorvardur R.
AU  - Starr, Jason
TI  - Evaluation of Hepatotoxicity from Peptide Receptor Radionuclide Therapy in Patients with Gastroenteropancreatic Neuroendocrine Tumors and a Very High Liver Tumor Burden
AID  - 10.2967/jnumed.122.264533
DP  - 2023 Jun 01
TA  - Journal of Nuclear Medicine
PG  - 880--884
VI  - 64
IP  - 6
4099  - http://jnm.snmjournals.org/content/64/6/880.short
4100  - http://jnm.snmjournals.org/content/64/6/880.full
SO  - J Nucl Med2023 Jun 01; 64
AB  - The aim of the current study was to describe the risk of hepatotoxicity for patients with gastroenteropancreatic neuroendocrine tumors undergoing peptide receptor radionuclide therapy (PRRT) with a very high liver tumor burden, defined as tumor involving more than 75% of the liver. Methods: We conducted a retrospective analysis of 371 patients who received at least 1 cycle of 177Lu-DOTATATE at Mayo Clinic for advanced gastroenteropancreatic neuroendocrine tumors. We identified 15 total patients with more than 75% liver involvement on 68Ga-DOTATATE PET/CT and with either a contrast-enhanced abdominal MRI or dual-phase abdominal CT examination. Results: Of the 15 patients with more than 75% liver involvement, 1 experienced hepatotoxicity (i.e., worsening liver enzymes or bilirubin) as defined by the Common Terminology Criteria for Adverse Events, version 5.0. No patients had grade 3–5 hepatotoxicity (i.e., clinical signs of liver failure). Conclusion: When considering the risk of liver injury from PRRT due to burden of disease, our data suggest that PRRT may be a safe option in patients with more than 75% liver involvement. Future efforts should be made to determine the safety profile of PRRT in patients with varying degrees of liver involvement.