RT Journal Article
SR Electronic
T1 Comparison of Somatostatin Receptor Agonist and Antagonist for Peptide Receptor Radionuclide Therapy: A Pilot Study
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1248
OP 1252
DO 10.2967/jnumed.114.138834
VO 55
IS 8
A1 Damian Wild
A1 Melpomeni Fani
A1 Richard Fischer
A1 Luigi Del Pozzo
A1 Felix Kaul
A1 Simone Krebs
A1 Richard Fischer
A1 Jean E.F. Rivier
A1 Jean Claude Reubi
A1 Helmut R. Maecke
A1 Wolfgang A. Weber
YR 2014
UL http://jnm.snmjournals.org/content/55/8/1248.abstract
AB Preclinical and clinical studies have indicated that somatostatin receptor (sst)–expressing tumors demonstrate higher uptake of radiolabeled sst antagonists than of sst agonists. In 4 consecutive patients with advanced neuroendocrine tumors, we evaluated whether treatment with 177Lu-labeled sst antagonists is feasible. Methods: After injection of approximately 1 GBq of 177Lu-DOTA-[Cpa-c(DCys-Aph(Hor)-DAph(Cbm)-Lys-Thr-Cys)-DTyr-NH2] (177Lu-DOTA-JR11) and 177Lu-DOTATATE, 3-dimensional voxel dosimetry analysis based on SPECT/CT was performed. A higher tumor-to-organ dose ratio for 177Lu-DOTA-JR11 than for 177Lu-DOTATATE was the prerequisite for treatment with 177Lu-DOTA-JR11. Results: Reversible minor adverse effects of 177Lu-DOTA-JR11 were observed. 177Lu-DOTA-JR11 showed a 1.7–10.6 times higher tumor dose than 177Lu-DOTATATE. At the same time, the tumor-to-kidney and tumor–to–bone marrow dose ratio was 1.1–7.2 times higher. All 4 patients were treated with 177Lu-DOTA-JR11, resulting in partial remission in 2 patients, stable disease in 1 patient, and mixed response in the other patient. Conclusion: Treatment of neuroendocrine tumors with radiolabeled sst antagonists is clinically feasible and may have a significant impact on peptide receptor radionuclide therapy.