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Radiolabelled somatostatin analogue treatment in gastroenteropancreatic neuroendocrine tumours: factors associated with response and suggestions for therapeutic sequence

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Abstract

Purpose

Peptide receptor radionuclide therapy (PRRT) is a relatively new treatment modality for patients with unresectable or metastatic gastroenteropancreatic neuroendocrine tumours (GEP NETs). The aim of this study was to determine the time to progression of patients treated with PRRT and to identify the prognostic factors related to treatment response.

Methods

Patients with sporadic GEP NETs prospectively treated with PRRT were retrospectively analysed. The primary end point was progression-free survival (PFS).

Results

A total of 69 patients (37 men and 32 women; 45 with pancreatic and 24 with gastrointestinal lesion; 22 NET G1 and 41 NET G2) were treated with 90Y or 177Lu. The objective response rate was 27.5 % (partial response, PR), while 50.7 % had stable disease and 23.2 % had progressive disease. Significant differences in PFS were observed in relationship to the stage of the disease (44 months for stage III, 23 months for stage IV), the evidence of a PR 6 months after the end of the PRRT (39 months in patients with a PR, 22 months in patients without a PR) and previous transarterial chemoembolization (TACE, yes 13 months vs no 31 months). Stage IV, NET G2 and previous TACE were found to be significant factors for tumour progression at multivariate analysis.

Conclusion

Low tumour burden and a low proliferation index represent independent prognostic factors for long PFS, while previous chemoembolization techniques represent independent prognostic factors for early tumour progression and shorter PFS. Our data suggest that chemoembolization techniques to reduce the hepatic tumour burden should be avoided.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy

    Davide Campana, Francesca Nori, Giulia Cacciari & Paola Tomassetti

  2. Digestive and Liver Disease Unit, “Sapienza” University of Rome, Rome, Italy

    Gabriele Capurso, Francesco Panzuto & Gianfranco Delle Fave

  3. Department of Surgery, Sacro Cuore Don Calabria Hospital, Negrar, Italy

    Stefano Partelli

  4. Department of Surgery, University of Verona, Verona, Italy

    Stefano Partelli, Domenico Tamburrino & Massimo Falconi

  5. Pancreas Surgical Unit, Università Politecnica delle Marche, Ancona, Italy

    Stefano Partelli, Domenico Tamburrino & Massimo Falconi

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  1. Davide Campana
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  2. Gabriele Capurso
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  3. Stefano Partelli
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  4. Francesca Nori
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  5. Francesco Panzuto
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  6. Domenico Tamburrino
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  7. Giulia Cacciari
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  8. Gianfranco Delle Fave
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  9. Massimo Falconi
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Correspondence to Davide Campana.

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Gianfranco Delle Fave and Massimo Falconi share the senior authorship.

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Campana, D., Capurso, G., Partelli, S. et al. Radiolabelled somatostatin analogue treatment in gastroenteropancreatic neuroendocrine tumours: factors associated with response and suggestions for therapeutic sequence. Eur J Nucl Med Mol Imaging 40, 1197–1205 (2013). https://doi.org/10.1007/s00259-013-2402-2

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  • DOI: https://doi.org/10.1007/s00259-013-2402-2

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