177Lu-DOTATATE Plus Radiosensitizing Capecitabine Versus Octreotide Long-Acting Release as First-Line Systemic Therapy in Advanced Grade 1 or 2 Gastroenteropancreatic Neuroendocrine Tumors: A Single-Institution Experience

被引:11
作者
Satapathy, Swayamjeet [1 ]
Mittal, Bhagwant R. [1 ]
Sood, Ashwani [1 ]
Sood, Apurva [1 ]
Kapoor, Rakesh [2 ]
Gupta, Rajesh [3 ]
Khosla, Divya [2 ]
机构
[1] Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India
[2] Post Grad Inst Med Educ & Res, Dept Radiotherapy, Chandigarh, India
[3] Post Grad Inst Med Educ & Res, Dept Surg Gastroenterol, Chandigarh, India
关键词
RECEPTOR RADIONUCLIDE THERAPY; QUALITY-OF-LIFE; LU-177-OCTREOTATE; SURVIVAL; DOTATATE; TOXICITY; DISEASE; SAFETY;
D O I
10.1200/GO.21.00103
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE To compare the efficacy and safety of Lu-177-DOTATATE plus radiosensitizing capecitabine and octreotide long-acting release (LAR) as first-line systemic therapy in advanced well-differentiated gastro-enteropancreatic neuroendocrine tumors (GEP-NETs). MATERIALS AND METHODS Data of consecutive patients of advanced inoperable or metastatic grade 1 or 2 GEPNETs treated with first-line Lu-177-DOTATATE plus radiosensitizing capecitabine or octreotide LAR from September 2012 to December 2019 were collected and analyzed for response, toxicity, and survival outcomes. RESULTS Seventy-six patients (median age: 53 years; range 14-81 years) with treatment-naive advanced grade 1 or 2 GEP-NETs were included. Thirty-six patients received a median cumulative dose of 27.3 GBq of Lu-177-DOTATATE intravenously at 8-12 weeks' intervals along with 1,250 mg/m(2) oral capecitabine on days 0-14 of each cycle of Lu-177-DOTATATE, whereas 40 patients were administered 30 mg octreotide LAR intramuscularly every 4 weeks. Using response evaluation criteria in solid tumor 1.1, the objective response rate was 38% in the Lu-177-DOTATATE arm compared with 15% in the octreotide LAR arm (P = .025), whereas the disease control rates were 88% and 67% in Lu-177-DOTATATE and octreotide LAR arms, respectively (P = .035). The median durations of progression-free survival in the Lu-177-DOTATATE and octreotide LAR arms were 54 months and 16 months, respectively (P = .017), whereas the median overall survival was not reached and not significantly different across both the arms. Of the treatment-related adverse events, no major difference was observed in the occurrence of grade 3 or 4 toxicities between the two treatment arms. CONCLUSION First-line systemic Lu-177-DOTATATE plus radiosensitizing capecitabine achieved better radiologic response and longer progression-free survival compared with octreotide LAR in patients with advanced grade 1 or 2 GEP-NETs. Future randomized controlled trials are, however, required to determine the best treatment sequence for the treatment-naive patients with advanced GEP-NETs. (C) 2021 by American Society of Clinical Oncology
引用
收藏
页码:1167 / 1175
页数:9
相关论文
共 25 条
[1]   Concomitant 177Lu-DOTATATE and Capecitabine Therapy in Patients With Advanced Neuroendocrine Tumors A Long-term-Outcome, Toxicity, Survival, and Quality-of-Life Study [J].
Ballal, Sanjana ;
Yadav, Madhav P. ;
Damle, Nishikant A. ;
Sahoo, Ranjit K. ;
Bal, Chandrasekhar .
CLINICAL NUCLEAR MEDICINE, 2017, 42 (11) :E457-E466
[2]   Peptide receptor radionuclide therapy with 177Lu-DOTATATE: the IEO phase I-II study [J].
Bodei, Lisa ;
Cremonesi, Marta ;
Grana, Chiara M. ;
Fazio, Nicola ;
Iodice, Simona ;
Baio, Silvia M. ;
Bartolomei, Mirco ;
Lombardo, Dario ;
Ferrari, Mahila E. ;
Sansovini, Maddalena ;
Chinol, Marco ;
Paganelli, Giovanni .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2011, 38 (12) :2125-2135
[3]   Octreotide LAR: safety and tolerability issues [J].
Bornschein, Jan ;
Drozdov, Ignat ;
Malfertheiner, Peter .
EXPERT OPINION ON DRUG SAFETY, 2009, 8 (06) :755-768
[4]   Long-Term Efficacy, Survival, and Safety of [177Lu-DOTA0, Tyr3] octreotate in Patients with Gastroenteropancreatic and Bronchial Neuroendocrine Tumors [J].
Brabander, Tessa ;
van der Zwan, Wouter A. ;
Teunissen, Jaap J. M. ;
Kam, Boen L. R. ;
Feelders, Richard A. ;
de Herder, Wouter W. ;
van Eijck, Casper H. J. ;
Franssen, Gaston J. H. ;
Krenning, Eric P. ;
Kwekkeboom, Dik J. .
CLINICAL CANCER RESEARCH, 2017, 23 (16) :4617-4624
[5]   Gastroenteropancreatic Neuroendocrine Tumors [J].
Cives, Mauro ;
Strosberg, Jonathan R. .
CA-A CANCER JOURNAL FOR CLINICIANS, 2018, 68 (06) :471-487
[6]   Phase II study of radiopeptide 177Lu-octreotate and capecitabine therapy of progressive disseminated neuroendocrine tumours [J].
Claringbold, Phillip G. ;
Brayshaw, Paul A. ;
Price, Richard A. ;
Turner, J. Harvey .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2011, 38 (02) :302-311
[7]   Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States [J].
Dasari, Arvind ;
Shen, Chan ;
Halperin, Daniel ;
Zhao, Bo ;
Zhou, Shouhao ;
Xu, Ying ;
Shih, Tina ;
Yao, James C. .
JAMA ONCOLOGY, 2017, 3 (10) :1335-1342
[8]   New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) [J].
Eisenhauer, E. A. ;
Therasse, P. ;
Bogaerts, J. ;
Schwartz, L. H. ;
Sargent, D. ;
Ford, R. ;
Dancey, J. ;
Arbuck, S. ;
Gwyther, S. ;
Mooney, M. ;
Rubinstein, L. ;
Shankar, L. ;
Dodd, L. ;
Kaplan, R. ;
Lacombe, D. ;
Verweij, J. .
EUROPEAN JOURNAL OF CANCER, 2009, 45 (02) :228-247
[9]   Predictors of Long-Term Outcome in Patients with Well-Differentiated Gastroenteropancreatic Neuroendocrine Tumors After Peptide Receptor Radionuclide Therapy with 177Lu-Octreotate [J].
Ezziddin, Samer ;
Attassi, Mared ;
Yong-Hing, Charlotte J. ;
Ahmadzadehfar, Hojjat ;
Willinek, Winfried ;
Gruenwald, Frank ;
Guhlke, Stefan ;
Biersack, Hans-Juergen ;
Sabet, Amir .
JOURNAL OF NUCLEAR MEDICINE, 2014, 55 (02) :183-190
[10]   Targeted Systemic Treatment of Neuroendocrine Tumors: Current Options and Future Perspectives [J].
Herrera-Martinez, Aura D. ;
Hofland, Johannes ;
Hofland, Leo J. ;
Brabander, Tessa ;
Eskens, Ferry A. L. M. ;
Galvez Moreno, Maria A. ;
Luque, Raul M. ;
Castano, Justo P. ;
de Herder, Wouter W. ;
Feelders, Richard A. .
DRUGS, 2019, 79 (01) :21-42