Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms
This study was performed to determine if intra-arterial (i.a.) administration of <sup>90</sup>Y DOTATATE can provide an effective and safe alternative to the accepted standard for i.v. of peptide receptor radionuclide therapy (PRRT) in liver-dominant metastases of gastrointestinal pancre...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/8/1794 |
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| author | Agnieszka Kolasińska-Ćwikła Mirosław L. Nowicki Artur J. Sankowski Jakub M. Pałucki John R. Buscombe Lidia Glinka Jarosław B. Ćwikła |
| author_facet | Agnieszka Kolasińska-Ćwikła Mirosław L. Nowicki Artur J. Sankowski Jakub M. Pałucki John R. Buscombe Lidia Glinka Jarosław B. Ćwikła |
| author_sort | Agnieszka Kolasińska-Ćwikła |
| collection | DOAJ |
| description | This study was performed to determine if intra-arterial (i.a.) administration of <sup>90</sup>Y DOTATATE can provide an effective and safe alternative to the accepted standard for i.v. of peptide receptor radionuclide therapy (PRRT) in liver-dominant metastases of gastrointestinal pancreatic neuroendocrine neoplasm (GEP-NEN). A single site, prospective, preliminary case series study included 39 patients with histologically proven liver-dominant NEN. PRRT in the form of 1.15GBq <sup>90</sup>Y DOTATATE was given selectively into the liver via radiological catheterization of the hepatic artery, up to four times. The endpoint was radiological response (RECIST). Secondary endpoints assessed clinical well-being post-treatment, progression-free survival (PFS), overall survival (OS), and toxicity. Partial response (PR) was noted in 13% of subjects six weeks post-therapy, increasing to 24% at six months and dropping to 13% at 36 months. Disease progression (DP) was not seen at six weeks, was 5% at six months, and 47% at 36 months. Clinical response based on PS seen in 74% of patients at six weeks, 69% at six months, and 39% at 36 months had PFS and OS, respectively, of 22.7 months and 38.2 months. There was no difference in OS/PFS between those with RECIST PR and SD. One patient had significant toxicity (3%). Use of i.a. PRRT appears to be safe and effective in treating patients with liver-dominant NEN. In addition, the best OS (51 vs. 22 months) was seen when i.a. was used as an upfront treatment of bulky GEP-NEN liver metastases and not after i.v. <sup>90</sup>Y DOTATATE. The use of i.a. <sup>90</sup>Y DOTATATE PRRT appears to be safe and effective in treating patients with liver-dominant NEN. |
| first_indexed | 2024-03-10T12:08:46Z |
| format | Article |
| id | doaj.art-930062c33f944a6498dcfc454f0b0be3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:08:46Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-930062c33f944a6498dcfc454f0b0be32023-11-21T16:21:37ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01108179410.3390/jcm10081794Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine NeoplasmsAgnieszka Kolasińska-Ćwikła0Mirosław L. Nowicki1Artur J. Sankowski2Jakub M. Pałucki3John R. Buscombe4Lidia Glinka5Jarosław B. Ćwikła6Department of Oncology and Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Wawelska 15, 02-034 Warsaw, PolandDepartment of Radiology, Hospital Ministry of Internal Affairs, Wołoska 137, 02-507 Warsaw, PolandDepartment of Radiology, Hospital Ministry of Internal Affairs, Wołoska 137, 02-507 Warsaw, PolandDepartment of Oncology and Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Wawelska 15, 02-034 Warsaw, PolandDepartment of Nuclear Medicine, Barts Health, West Smithfield, London EC1A 7BE, UKDepartment of Cardiology and Internal Medicine, School of Medicine, University of Warmia and Mazury, Warszawska 30, 10-082 Olsztyn, PolandDepartment of Cardiology and Internal Medicine, School of Medicine, University of Warmia and Mazury, Warszawska 30, 10-082 Olsztyn, PolandThis study was performed to determine if intra-arterial (i.a.) administration of <sup>90</sup>Y DOTATATE can provide an effective and safe alternative to the accepted standard for i.v. of peptide receptor radionuclide therapy (PRRT) in liver-dominant metastases of gastrointestinal pancreatic neuroendocrine neoplasm (GEP-NEN). A single site, prospective, preliminary case series study included 39 patients with histologically proven liver-dominant NEN. PRRT in the form of 1.15GBq <sup>90</sup>Y DOTATATE was given selectively into the liver via radiological catheterization of the hepatic artery, up to four times. The endpoint was radiological response (RECIST). Secondary endpoints assessed clinical well-being post-treatment, progression-free survival (PFS), overall survival (OS), and toxicity. Partial response (PR) was noted in 13% of subjects six weeks post-therapy, increasing to 24% at six months and dropping to 13% at 36 months. Disease progression (DP) was not seen at six weeks, was 5% at six months, and 47% at 36 months. Clinical response based on PS seen in 74% of patients at six weeks, 69% at six months, and 39% at 36 months had PFS and OS, respectively, of 22.7 months and 38.2 months. There was no difference in OS/PFS between those with RECIST PR and SD. One patient had significant toxicity (3%). Use of i.a. PRRT appears to be safe and effective in treating patients with liver-dominant NEN. In addition, the best OS (51 vs. 22 months) was seen when i.a. was used as an upfront treatment of bulky GEP-NEN liver metastases and not after i.v. <sup>90</sup>Y DOTATATE. The use of i.a. <sup>90</sup>Y DOTATATE PRRT appears to be safe and effective in treating patients with liver-dominant NEN.https://www.mdpi.com/2077-0383/10/8/1794neuroendocrine neoplasmsPRRT-intra-arterial (i.a.)<sup>90</sup>Y-DOTATATEradiological and clinical responseOSPFS |
| spellingShingle | Agnieszka Kolasińska-Ćwikła Mirosław L. Nowicki Artur J. Sankowski Jakub M. Pałucki John R. Buscombe Lidia Glinka Jarosław B. Ćwikła Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms Journal of Clinical Medicine neuroendocrine neoplasms PRRT-intra-arterial (i.a.) <sup>90</sup>Y-DOTATATE radiological and clinical response OS PFS |
| title | Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms |
| title_full | Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms |
| title_fullStr | Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms |
| title_full_unstemmed | Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms |
| title_short | Radiological and Clinical Efficacy of Intra-Arterial <sup>90</sup>Y-DOTATATE in Patients with Unresectable, Progressive, Liver Dominant Neuroendocrine Neoplasms |
| title_sort | radiological and clinical efficacy of intra arterial sup 90 sup y dotatate in patients with unresectable progressive liver dominant neuroendocrine neoplasms |
| topic | neuroendocrine neoplasms PRRT-intra-arterial (i.a.) <sup>90</sup>Y-DOTATATE radiological and clinical response OS PFS |
| url | https://www.mdpi.com/2077-0383/10/8/1794 |
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