Neuroendocrine tumors. Peptide receptor radionuclide therapy

Best Pract Res Clin Endocrinol Metab. 2007 Mar;21(1):111-29. doi: 10.1016/j.beem.2007.01.007.

Abstract

Peptide receptor radionuclide therapy with radiolabelled somatostatin analogues is an emerging and convincing treatment modality for patients with unresectable, somatostatin-receptor-positive neuroendocrine tumours. Using radiolabelled somatostatin analogues for imaging became the gold standard for staging of neuroendocrine tumours. The somatostatin receptor is strongly over-expressed in most tumours, resulting in high tumour-to-background ratios. Consequently, the next step was to try to treat these patients by increasing the radioactivity of the administered radiolabelled somatostatin analogue in an attempt to bring about tumour cure. Many patients have been treated successfully with this approach, roughly 25% of them achieving objective tumour shrinkage >50%. Serious side-effects have been rare. This article reviews the effectiveness and safety of the different radiolabelled somatostatin analogues used. Furthermore, clinical issues--including indication and timing of therapy--are discussed. Finally, important directions for future research are mentioned to illustrate new strategies for increasing therapy efficacy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood / drug effects
  • Heterocyclic Compounds / adverse effects
  • Heterocyclic Compounds / therapeutic use
  • Humans
  • Kidney / drug effects
  • Liver / drug effects
  • Neuroendocrine Tumors / therapy*
  • Octreotide / adverse effects
  • Octreotide / analogs & derivatives
  • Octreotide / therapeutic use
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / therapeutic use
  • Pentetic Acid / adverse effects
  • Pentetic Acid / analogs & derivatives
  • Pentetic Acid / therapeutic use
  • Radioisotopes / adverse effects
  • Radioisotopes / therapeutic use*
  • Receptors, Peptide / therapeutic use*
  • Somatostatin / adverse effects
  • Somatostatin / analogs & derivatives*
  • Somatostatin / therapeutic use*
  • Time Factors

Substances

  • Heterocyclic Compounds
  • Organometallic Compounds
  • Radioisotopes
  • Receptors, Peptide
  • yttrium(III)-1,4,7,10-tetraazacyclotetradecane-N,N',N'',N'''-tetraacetic acid
  • SDZ 215-811
  • Somatostatin
  • Pentetic Acid
  • Octreotide
  • Edotreotide