神经内分泌肿瘤(NENs)是一类非常多样化的肿瘤,发病率在全球范围内上升。全身治疗仍然是不可切除和/或转移性NEN的主要治疗方法。177Lu-DOTATATE,一种发射β粒子的放射性药物,已成为转移性胃肠胰腺神经内分泌肿瘤(GEP-NENs)的有希望的治疗方法。然而,特别是177Lu-DOTATATE治疗失败后,可选择的治疗方案有限.这篇综述旨在确定和总结现有的证据,和潜在的不良事件,靶向α粒子疗法(TAT)治疗转移性NENs,特别是GEP-NENs。MEDLINE,EMBASE,Scopus,搜索了Cochrane图书馆数据库。确定了符合纳入标准的两篇文章,并将其纳入审查。可以考虑用于转移性NEN治疗的推定的放射性药物包括225Actinium(225Ac)-DOTATATE和213铋(213Bi)-DOTATOC。有证据表明,使用两种放射性药物均有部分反应,但没有明显的血液学,肾,或肝毒性。未来的研究应该考虑更长期的,研究TAT作用的随机对照试验,特别是,225Ac-DOTATATE,在转移性NENs的治疗中。
Neuroendocrine neoplasms (NENs) are a very diverse group of tumors with a worldwide rise in incidence. Systemic therapy remains the mainstay treatment for unresectable and/or metastatic NENs. 177Lu-DOTATATE, a radiopharmaceutical which emits beta particles, has emerged as a promising therapy for metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, limited treatment options are available particularly after the failure of 177Lu-DOTATATE therapy. This
review aims to identify and summarize the available evidence for, and potential adverse events of, targeted alpha-particle therapy (TAT) in the treatment of metastatic NENs, specifically GEP-NENs. The MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases were searched. Two articles which met the inclusion criteria were identified and included in the
review. Putative radiopharmaceuticals that can be considered for metastatic NEN treatment include 225Actinium (225Ac)-DOTATATE and 213Bismuth (213Bi)-DOTATOC. There was evidence of partial response using both radiopharmaceutical agents without significant hematological, renal, or hepatotoxicity. Future studies should consider longer term, randomized controlled trials investigating the role of TAT, in particular, 225Ac-DOTATATE, in the treatment of metastatic NENs.