Outcome and toxicity of salvage therapy with (177)Lu-octreotate in patients with metastatic gastroenteropancreatic neuroendocrine tumours (Springer Link, 13 September 2013)

Peptide receptor targeted therapy with Lutetium-Octreotate therapy is a well-established treatment for patients’ metastatic neuroendocrine tumours. This study assesses the effectiveness and safety of re-treatment or salvage therapy with further Lutetium-Octreotate therapy in patients that have progressed after previous treatment.

This study analysed the response of 33 patients who had been re-treated with PRRT following development of progressive disease. The majority of patients were re-treated with 2 cycles; a few had a 3 or 4 cycles. The results demonstrated radiographic responses consisted of complete response in 1 patient (3.0 %), partial response in 6 patients (18.2 %), minor response in 1 patient (3.0 %), stable disease

in 14 patients (42.4 %), and progressive disease in 11 patients (33.3 %). Median progression-free survival (PFS) from the start of salvage therapy was 13 months (95 % CI 9–18 months). None of the patients developed severe nephrotoxicity (grade 3/4) or a myelodysplastic syndrome during follow-up. Relevant albeit reversible haematotoxicity (grade 3/4) occurred in 7 patients (21.2 %). The cumulative administered activity was not associated with an increased incidence of haematotoxicity.

Importantly, previously good response to PRRT was associated with a longer response on re-treatment. Also there were no episodes of severe nephrotoxicity.

In conclusion, this small study demonstrates that re-treatment with PRRT appears to be safe and an effective treatment option for patients with progressive metastatic disease.

Source: Springer Link (published study)