Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls
Abstract Background For progressive metastatic medullary thyroid carcinoma (MTC), the available treatment options with tyrosine kinase inhibitors result in grade 3–4 adverse events in a large number of patients. Peptide Receptor Radionuclide Therapy (PRRT), which has also been suggested to be a usef...
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BMC
2019-04-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-019-5540-5 |
| _version_ | 1818392067928227840 |
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| author | Carolien M. Beukhof Tessa Brabander Francien H. van Nederveen Marie-Louise F. van Velthuysen Yolanda B. de Rijke Leo J. Hofland Gaston J. H. Franssen Lideke A. C. Fröberg Boen L. R. Kam W. Edward Visser Wouter W. de Herder Robin P. Peeters |
| author_facet | Carolien M. Beukhof Tessa Brabander Francien H. van Nederveen Marie-Louise F. van Velthuysen Yolanda B. de Rijke Leo J. Hofland Gaston J. H. Franssen Lideke A. C. Fröberg Boen L. R. Kam W. Edward Visser Wouter W. de Herder Robin P. Peeters |
| author_sort | Carolien M. Beukhof |
| collection | DOAJ |
| description | Abstract Background For progressive metastatic medullary thyroid carcinoma (MTC), the available treatment options with tyrosine kinase inhibitors result in grade 3–4 adverse events in a large number of patients. Peptide Receptor Radionuclide Therapy (PRRT), which has also been suggested to be a useful treatment for MTC, is usually well tolerated, but evidence on its effectivity is very limited. Methods Retrospective evaluation of treatment effects of PRRT in a highly selected group of MTC patients, with progressive disease or refractory symptoms. In addition, a retrospective evaluation of uptake on historical 111In-DTPA-octreotide scans was performed in patients with detectable tumor size > 1 cm. Results Over the last 17 years, 10 MTC patients were treated with PRRT. Four out of 10 patients showed stable disease at first follow-up (8 months after start of therapy) whereas the other 6 were progressive. Patients with stable disease were characterized by a combination of both a high uptake on 111In-DTPA-octreotide scan (uptake grade ≥ 3) and a positive somatostatin receptor type 2a (SSTR2a) expression of the tumor by immunohistochemistry. Retrospective evaluation of historical 111In-DTPA-octreotide scans of 35 non-treated MTC patients revealed low uptake (uptake grade 1) in the vast majority of patients 31/35 (89%) with intermediate uptake (uptake grade 2) in the remaining 4/35 (11%). Conclusions PRRT using 177Lu-octreotate could be considered as a treatment in those patients with high uptake on 111In-DTPA-octreotide scan (uptake grade 3) and positive SSTR2a expression in tumor histology. Since this high uptake was present in a very limited number of patients, this treatment is only suitable in a selected group of MTC patients. |
| first_indexed | 2024-12-14T05:23:32Z |
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| id | doaj.art-cb9f8419899e432baf094b33989be84a |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-14T05:23:32Z |
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| series | BMC Cancer |
| spelling | doaj.art-cb9f8419899e432baf094b33989be84a2022-12-21T23:15:35ZengBMCBMC Cancer1471-24072019-04-011911810.1186/s12885-019-5540-5Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfallsCarolien M. Beukhof0Tessa Brabander1Francien H. van Nederveen2Marie-Louise F. van Velthuysen3Yolanda B. de Rijke4Leo J. Hofland5Gaston J. H. Franssen6Lideke A. C. Fröberg7Boen L. R. Kam8W. Edward Visser9Wouter W. de Herder10Robin P. Peeters11Erasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceErasmus MC, Department of Radiology & Nuclear Medicine, Erasmus University Medical CenterErasmus MC, Department of Pathology, Erasmus University Medical CenterErasmus MC, Department of Pathology, Erasmus University Medical CenterErasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceErasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceErasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceErasmus MC, Department of Radiology & Nuclear Medicine, Erasmus University Medical CenterErasmus MC, Department of Radiology & Nuclear Medicine, Erasmus University Medical CenterErasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceErasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceErasmus MC, Department of Internal Medicine, Academic Center for Thyroid Diseases, European Neuroendocrine Tumor Society center of excellenceAbstract Background For progressive metastatic medullary thyroid carcinoma (MTC), the available treatment options with tyrosine kinase inhibitors result in grade 3–4 adverse events in a large number of patients. Peptide Receptor Radionuclide Therapy (PRRT), which has also been suggested to be a useful treatment for MTC, is usually well tolerated, but evidence on its effectivity is very limited. Methods Retrospective evaluation of treatment effects of PRRT in a highly selected group of MTC patients, with progressive disease or refractory symptoms. In addition, a retrospective evaluation of uptake on historical 111In-DTPA-octreotide scans was performed in patients with detectable tumor size > 1 cm. Results Over the last 17 years, 10 MTC patients were treated with PRRT. Four out of 10 patients showed stable disease at first follow-up (8 months after start of therapy) whereas the other 6 were progressive. Patients with stable disease were characterized by a combination of both a high uptake on 111In-DTPA-octreotide scan (uptake grade ≥ 3) and a positive somatostatin receptor type 2a (SSTR2a) expression of the tumor by immunohistochemistry. Retrospective evaluation of historical 111In-DTPA-octreotide scans of 35 non-treated MTC patients revealed low uptake (uptake grade 1) in the vast majority of patients 31/35 (89%) with intermediate uptake (uptake grade 2) in the remaining 4/35 (11%). Conclusions PRRT using 177Lu-octreotate could be considered as a treatment in those patients with high uptake on 111In-DTPA-octreotide scan (uptake grade 3) and positive SSTR2a expression in tumor histology. Since this high uptake was present in a very limited number of patients, this treatment is only suitable in a selected group of MTC patients.http://link.springer.com/article/10.1186/s12885-019-5540-5Thyroid cancer, medullaryPeptide receptor radionuclide therapyLutetiumReceptors, somatostatin |
| spellingShingle | Carolien M. Beukhof Tessa Brabander Francien H. van Nederveen Marie-Louise F. van Velthuysen Yolanda B. de Rijke Leo J. Hofland Gaston J. H. Franssen Lideke A. C. Fröberg Boen L. R. Kam W. Edward Visser Wouter W. de Herder Robin P. Peeters Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls BMC Cancer Thyroid cancer, medullary Peptide receptor radionuclide therapy Lutetium Receptors, somatostatin |
| title | Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls |
| title_full | Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls |
| title_fullStr | Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls |
| title_full_unstemmed | Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls |
| title_short | Peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma: predictors and pitfalls |
| title_sort | peptide receptor radionuclide therapy in patients with medullary thyroid carcinoma predictors and pitfalls |
| topic | Thyroid cancer, medullary Peptide receptor radionuclide therapy Lutetium Receptors, somatostatin |
| url | http://link.springer.com/article/10.1186/s12885-019-5540-5 |
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