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Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours

Romer, A. ; Seiler, D. ; Marincek, N. ; Brunner, P. ; Koller, M. ; Ng, Q. ; Maecke, H. ; Müller-Brand, J. ; Rochlitz, C. ; Briel, M. ; Schindler, C. ; Walter, M.

In: European Journal of Nuclear Medicine and Molecular Imaging, 2014, vol. 41, no. 2, p. 214-222

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    Titre
    • Somatostatin-based radiopeptide therapy with [177Lu-DOTA]-TOC versus [90Y-DOTA]-TOC in neuroendocrine tumours
    Auteur
    • Romer, A.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    • Seiler, D.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    • Marincek, N.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    • Brunner, P.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    • Koller, M.. Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland
    • Ng, Q.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    • Maecke, H.. Division of Radiochemistry, University Hospital Basel, Basel, Switzerland
    • Müller-Brand, J.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    • Rochlitz, C.. Department of Oncology, University Hospital Basel, Basel, Switzerland
    • Briel, M.. Institute of Nuclear Medicine, University Hospital Bern, Haller Building, Freiburgstrasse 4, 3010, Bern, Switzerland
    • Schindler, C.. Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
    • Walter, M.. Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Journal of Nuclear Medicine and Molecular Imaging, 2014, vol. 41, no. 2, p. 214-222. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:324831
    Summary
    Purpose: Somatostatin-based radiopeptide treatment is generally performed using the β-emitting radionuclides 90Y or 177Lu. The present study aimed at comparing benefits and harms of both therapeutic approaches. Methods: In a comparative cohort study, patients with advanced neuroendocrine tumours underwent repeated cycles of [90Y-DOTA]-TOC or [177Lu-DOTA]-TOC until progression of disease or permanent adverse events. Multivariable Cox regression and competing risks regression were employed to examine predictors of survival and adverse events for both treatment groups. Results: Overall, 910 patients underwent 1,804cycles of [90Y-DOTA]-TOC and 141 patients underwent 259cycles of [177Lu-DOTA]-TOC. The median survival after [177Lu-DOTA]-TOC and after [90Y-DOTA]-TOC was comparable (45.5months versus 35.9months, hazard ratio 0.91, 95% confidence interval 0.63-1.30, p = 0.49). Subgroup analyses revealed a significantly longer survival for [177Lu-DOTA]-TOC over [90Y-DOTA]-TOC in patients with low tumour uptake, solitary lesions and extra-hepatic lesions. The rate of severe transient haematotoxicities was lower after [177Lu-DOTA]-TOC treatment (1.4 vs 10.1%, p = 0.001), while the rate of severe permanent renal toxicities was similar in both treatment groups (9.2 vs 7.8%, p = 0.32). Conclusion: The present results revealed no difference in median overall survival after [177Lu-DOTA]-TOC and [90Y-DOTA]-TOC. Furthermore, [177Lu-DOTA]-TOC was less haematotoxic than [90Y-DOTA]-TOC.