{Reference Type}: Journal Article
{Title}: Intra-arterial PRRT with Lu-177 DOTATATE in Liver-dominant Metastatic Neuroendocrine Tumors: Early Assessment of Efficacy and Toxicity.
{Author}: Puranik AD;Rangarajan V;Shetty NS;Gala K;Kulkarni S;Mohite A;Marotkar M;Gawale Y;Dev ID;Shrikhande SV;Chaudhari V;Bhandare M;Agrawal A;Shah S;Purandare NC;Ghosh S;Choudhury S;
{Journal}: Indian J Nucl Med
{Volume}: 39
{Issue}: 2
{Year}: 2024 Mar-Apr
暂无{DOI}: 10.4103/ijnm.ijnm_7_23
{Abstract}: <B>UNASSIGNED: </B>We proposed to administer Lu-177-DOTATATE in intra-arterial (IA) mode for higher first-pass localization to somatostatin receptors, higher residence time in liver metastases, and more radiation to tumor. This study aimed at assessing early hematological, renal and hepatotoxicity; and objective response to IA peptide receptor radionuclide therapy (PRRT).<BR><B>UNASSIGNED: </B>Fourteen patients (4 females and 10 males) were prospectively assessed. 5/14 patients underwent 2 cycles, whereas 3/14 underwent 3 cycles, and 6/14 received 1 cycle of IA PRRT. 200 mCi of Lu-177-DOTATATE was administered in 15-20 min by IA route under angiographic guidance. Patients were asked to follow-up at 4 and 8 weeks with hematological, liver, and renal functional parameters, and Ga-68 DOTATATE positron emission tomography/computed tomography (PET/CT) after 8 weeks. Response was assessed using RECIST 1.1 and EORTC PET criteria.<BR><B>UNASSIGNED: </B>Safety: 2/14 patients had high total and direct bilirubin, which reverted to normal after IA PRRT. Three patients had low albumin, which improved after 1 cycle. Nine patients showed no worsening of liver function. Two patients showed Grade 1 hematotoxicity which reverted to normal. Five patients showed high creatinine, but preserved glomerular filtration rate and EC clearance. On follow-up at 8 weeks, serum creatinine reverted to normal. Efficacy: In five patients who underwent 2 cycles of IA PRRT, 3 showed partial response (PR) on RECIST 1.1 and partial metabolic response (PMR) on EORTC criteria, whereas 2 showed stable disease (SD). In patients who underwent 3 cycles, 1 showed SD, whereas other patient showed PMR on DOTANOC PET/CT, with PR in size. Among the remaining seven patients, 5 showed PMR, whereas the other 2 showed SD. Thus 9/14 patients showed PR, whereas 5 showed SD on metabolic and size criteria.<BR><B>UNASSIGNED: </B>IA PRRT is a safe and efficacious approach for the treatment of liver dominant metastatic neuroendocrine tumors.