| Added by | JPPOUGET |
|---|---|
| Group name | EquipeJPP |
| Item Type | Journal Article |
| Title | Absorbed Dose-Response Relationship in Patients with Gastroenteropancreatic Neuroendocrine Tumors Treated with [177Lu]Lu-DOTATATE: One Step Closer to Personalized Medicine |
| Creator | Hebert et al. |
| Author | Lore Santoro |
| Author | Maeva Monnier |
| Author | Florence Castan |
| Author | Ikrame Berkane |
| Author | Cyril Fersing |
| Author | Pauline Gélibert |
| Author | Jean-Pierre Pouget |
| Author | Manuel Bardiès |
| Author | Pierre-Olivier Kotzki |
| Author | Emmanuel Deshayes |
| Abstract | [177Lu]Lu-DOTATATE has been approved for progressive and inoperable gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that overexpress somatostatin receptors. The absorbed doses by limiting organs and tumors can be quantified by serial postinfusion scintigraphy measurements of the ?-emissions from 177Lu. The objective of this work was to explore how postinfusion [177Lu]Lu-DOTATATE dosimetry could influence clinical management by predicting treatment efficacy (tumor shrinkage and survival) and toxicity. Methods: Patients with GEP-NETs treated with [177Lu]Lu-DOTATATE between 2016 and 2022 and who underwent dosimetry were included. Absorbed doses were calculated for healthy organs (liver, kidneys, bone marrow, and spleen) and tumors using PLANET Dose and the local energy deposition method based on serial posttreatment SPECT/CT. Up to 5 lesions per site were selected and measured on images collected at baseline and 3?mo after treatment end (measurement masked to the somatostatin receptor imaging uptake). For toxicity assessment, laboratory parameters were regularly monitored. Clinical data, including time to death or progression, were collected from the patients' health records. Correlations between absorbed doses by organs and toxicity and between absorbed doses by lesions and tumor volume variation were studied using regression models. Results: In total, 35 dosimetric studies were performed in patients with mostly grade 2 (77%) tumors and metastases in liver (89%), lymph nodes (77%), and bone (34%), and 146 lesions were analyzed: 1-9 lesions per patient, mostly liver metastases (65%) and lymph nodes (25%). The median total absorbed dose by tumors was 94.4?Gy. The absorbed doses by tumors significantly decreased between cycles. The absorbed dose by tumors was significantly associated with tumor volume variation (P < 0.001) 3?mo after treatment end, and it was a significant prognostic factor for survival. Toxicity analysis showed a correlation between the decrease of hematologic parameters such as lymphocytes or platelet concentrations and the absorbed doses by the spleen or bone marrow. The mean absorbed dose by the kidneys was not correlated with nephrotoxicity during the studied period. Conclusion: In patients treated with [177Lu]Lu-DOTATATE for GEP-NETs, tumor and healthy organ dosimetry can predict survival and toxicities, thus influencing clinical management. |
| Publication | Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine |
| Volume | 65 |
| Issue | 6 |
| Pages | 923-930 |
| Date | 2024-06-03 |
| Journal Abbr | J Nucl Med |
| Language | eng |
| DOI | 10.2967/jnumed.123.267023 |
| ISSN | 1535-5667 |
| Short Title | Absorbed Dose-Response Relationship in Patients with Gastroenteropancreatic Neuroendocrine Tumors Treated with [177Lu]Lu-DOTATATE |
| Library Catalog | PubMed |
| Extra | PMID: 38637144 PMCID: PMC11149595 |
| Tags | absorbed dose - response relationship, Adult, Aged, Aged, 80 and over, clinic, Dose-Response Relationship, Radiation, Female, first-last-coresponding, Humans, Intestinal Neoplasms, Male, Middle Aged, Neuroendocrine Tumors, Octreotide, Organometallic Compounds, original, Pancreatic Neoplasms, Precision Medicine, Radiometry, Retrospective Studies, Stomach Neoplasms, topjp, Treatment Outcome, [177Lu]Lu-DOTATATE |
| Date Added | 2024/12/07 - 07:04:06 |
| Date Modified | 2025/01/10 - 13:05:50 |
| Notes and Attachments | Full Text (Attachment) PubMed entry (Attachment) PubMed entry (Attachment) |
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