RT Journal Article
SR Electronic
T1 Comprehensive Characterization via Molecular Imaging, Longitudinal Multisite Sampling, and Autoptic Work-up in Advanced Small Cell Lung Cancer Undergoing SSTR-Directed Radiopharmaceutical Therapy
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.124.268513
DO 10.2967/jnumed.124.268513
A1 Enke, Johanna S.
A1 Reitsam, Nic G.
A1 Dintner, Sebastian
A1 Liesche-Starnecker, Friederike
A1 Schaller, Tina
A1 Decker, Josua A.
A1 Langer, Angela
A1 Sipos, Eva
A1 Antic Nikolic, Ana
A1 Kröncke, Thomas
A1 Trepel, Martin
A1 Lapa, Constantin
A1 Claus, Rainer
A1 Märkl, Bruno
A1 Bundschuh, Ralph A.
YR 2025
UL http://jnm.snmjournals.org/content/early/2025/01/16/jnumed.124.268513.abstract
AB Despite the addition of immune checkpoint blockade to first-line chemotherapy, the prognosis for patients with small cell lung cancer (SCLC) is still devastating. For the subset of SCLC with somatostatin receptor (SSTR) overexpression, radiopharmaceutical therapy (RPT) might be an effective future treatment option. Methods: Here, we present the case of a heavily pretreated stage IV SCLC patient showing an exceptional response to SSTR-directed RPT. A comprehensive translational work-up consisting of histopathologic, immunohistochemical, and molecular pathology analyses at different time points during treatment and especially of lesions with discordant tracer uptake was performed. Results: Besides a promising response to RPT, interesting signs of clonal dynamics under therapy and, most importantly, SSTR downregulation of some lesions as a potential evasion mechanism to SSTR-directed RPT could be identified. Conclusion: This unique investigation for a clinical–molecular understanding of novel treatment paradigms in SCLC may provide the basis for future treatment designs.