PT  - JOURNAL ARTICLE
AU  - Kulkarni, Harshad
AU  - Baum, Richard
AU  - Kaemmerer, Daniel
AU  - Petrovitch, Alexander
AU  - Hommann, Merten
AU  - Hörsch, Dieter
TI  - Efficacy of single- or duo-radionuclide peptide receptor radionuclide therapy (PRRT) in 1000 patients with neuroendocrine neoplasms (NENs): Analysis from a single center over more than 10 years
DP  - 2014 May 01
TA  - Journal of Nuclear Medicine
PG  - 396--396
VI  - 55
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/55/supplement_1/396.short
4100  - http://jnm.snmjournals.org/content/55/supplement_1/396.full
SO  - J Nucl Med2014 May 01; 55
AB  - 396 Objectives To assess the efficacy of PRRT using a single radionuclide (SN-PRRT) approach, or a combination of both (DUO-PRRT) Lu-177 / Y-90 in the same setting (tandem) or in sequence, in 1000 patients with NENs. Methods We retrospectively analyzed the results in 1000 patients (age 4 - 85 years) with metastatic, progressive NENs, undergoing 1 to 9 cycles of PRRT at our center, using Lu-177 (n=331), Y-90 (n=170) or both (n=499). The median administered radioactivity was 17.5 GBq. Most patients (95.6 %) underwent at least one previous other therapy (surgery in 86.8 %, medical therapy in 55 %, ablative therapy in 14.2 % and radiotherapy in 3.4 %). Results The median overall survival (OS) for all patients from start of PRRT was 52 months (mo). Median OS varied according to the radionuclide used: for SN-PRRT, it was 24 mo with Y-90 (including patients with very high tumor load and short survival), and 55 mo for Lu-177, whereas for DUO-PRRT it was 64 mo. According to the tumor grade, the median OS was 87 mo for G1, 55 mo for G2, and 28 mo for G3. Depending on the primary tumor origin, it was 45 mo for pancreas, 77 mo for small intestine, 55 mo for unknown primary, and 36 mo for lung carcinoids. The median progression-free survival (PFS) from the last therapy cycle was 22 mo, similar for pancreatic (23 mo) and small intestinal (25 mo) NENs. Conclusions DUO-PRRT, combining Lu-177 and Y-90 in sequence or concurrently, seems to be more effective than single radionuclide PRRT. Regardless of previous therapy, PRRT leads to a significant survival benefit in metastasized, progressive G1-2 NENs, which is especially true for small intestinal NEN, when compared to other treatment modalities.