Long-Term Efficacy, Survival, and Safety of [Lu-DOTA,Tyr]octreotate in Patients with Gastroenteropancreatic and Bronchial Neuroendocrine Tumors

Bronchial and gastroenteropancreatic neuroendocrine tumors (NET) are slow-growing tumors, which frequently express somatostatin receptors on their cell membranes. These receptors are targets for therapy with Lutetium-177-labeled somatostatin analogues. We have treated over 1,200 patients with peptide receptor radionuclide therapy (PRRT) with [Lu-DOTA,Tyr]octreotate (Lu-DOTATATE) since the year 2000 and present the results on efficacy, survival, and toxicity of this therapy. For safety analysis, 610 patients treated with a cumulative dose of at least 100 mCi (3.7 GBq) Lu-DOTATATE were included. A subgroup of 443 Dutch patients who were treated with a cumulative dose of at least 600 mCi (22.2 GBq) Lu-DOTATATE before 2013 was further analyzed for efficacy and survival. The objective response rate of the total group of patients was 39%. Stable disease was reached in 43% of patients. Progression-free survival (PFS) and overall survival (OS) for all NET patients were 29 months [95% confidence interval (CI), 26-33 months] and 63 months (95% CI, 55-72 months). Long-term toxicity included acute leukemia in four patients (0.7%) and myelodysplastic syndrome in nine patients (1.5%). No therapy-related long-term renal or hepatic failure occurred. PRRT with Lu-DOTATATE is a favorable therapeutic option in patients with metastatic bronchial and gastroenteropancreatic NETs that express somatostatin receptors. PRRT with Lu-DOTATATE is safe with few side-effects and shows good response rates with PFS of 29 months and OS of 63 months. .