共 25 条
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
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Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India

Mittal, Bhagwant R.
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Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India

Sood, Ashwani
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Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India

Sood, Apurva
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Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India

Kapoor, Rakesh
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Post Grad Inst Med Educ & Res, Dept Radiotherapy, Chandigarh, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India

Gupta, Rajesh
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Post Grad Inst Med Educ & Res, Dept Surg Gastroenterol, Chandigarh, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India

Khosla, Divya
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Post Grad Inst Med Educ & Res, Dept Radiotherapy, Chandigarh, India Post Grad Inst Med Educ & Res, Dept Nucl Med, Chandigarh 160012, India
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
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页码:1167 / 1175
页数:9
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Univ Hosp, Dept Nucl Med, D-53105 Bonn, Germany Univ Hosp, Dept Nucl Med, D-53105 Bonn, Germany

Sabet, Amir
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Univ Hosp, Dept Nucl Med, D-53105 Bonn, Germany Univ Hosp, Dept Nucl Med, D-53105 Bonn, Germany
[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

Herrera-Martinez, Aura D.
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Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands
Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Hofland, Johannes
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Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Hofland, Leo J.
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Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Brabander, Tessa
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机构:
Erasmus MC, Dept Radiol & Nucl Med, Rotterdam, Netherlands Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Eskens, Ferry A. L. M.
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Erasmus MC, Dept Med Oncol, Rotterdam, Netherlands Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Galvez Moreno, Maria A.
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Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Luque, Raul M.
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Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Castano, Justo P.
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Maimonides Inst Biomed Res Cordoba IMIBIC, Cordoba, Spain Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

de Herder, Wouter W.
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Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands

Feelders, Richard A.
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Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands Univ Med Ctr Rotterdam, Erasmus Med Ctr, ENETS Ctr Excellence Neuroendocrine Tumors, Dept Internal Med,Div Endocrinol, Dr Molewaterpl 40, NL-3015 GD Rotterdam, Netherlands