Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors
Purpose FDG-positive neuroendocrine tumors (NETs) have a poorer prognosis and exhibit shorter response duration to peptide receptor radionuclide therapy (PRRT). The aim of this prospective phase II study was to evaluate the efficacy and toxicity of PRRT with 177 Lu-DOTATATE associated with metronomi...
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| Veröffentlicht in: | European journal of nuclear medicine and molecular imaging 2021-09, Vol.48 (10), p.3260-3267 |
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| creator | Nicolini, Silvia Bodei, Lisa Bongiovanni, Alberto Sansovini, Maddalena Grassi, Ilaria Ibrahim, Toni Monti, Manuela Caroli, Paola Sarnelli, Anna Diano, Danila Di Iorio, Valentina Grana, Chiara Maria Cittanti, Corrado Pieri, Federica Severi, Stefano Paganelli, Giovanni |
| description | Purpose
FDG-positive neuroendocrine tumors (NETs) have a poorer prognosis and exhibit shorter response duration to peptide receptor radionuclide therapy (PRRT). The aim of this prospective phase II study was to evaluate the efficacy and toxicity of PRRT with
177
Lu-DOTATATE associated with metronomic capecitabine as a radiosensitizer agent in patients with advanced progressive FDG-positive gastro-entero-pancreatic (GEP) NETs.
Patients and methods
Patients with advanced somatostatin receptor- and FDG-positive G1-G3 GEP-NETs (Ki67 |
| doi_str_mv | 10.1007/s00259-021-05236-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9346628</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2570330116</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-692a11f3c762f81d2e8ade5074f2676074d05aacd1b94aa467a552dc1ef07d713</originalsourceid><addsrcrecordid>eNp9kU2LFDEQhhtR3HX1D3iQgJf1EK2k00nnIiyzHwoDe1nBW8gk1WOW6WRMuhfckz_djLOOHwfJoQL1vG9V8TbNSwZvGYB6VwB4pylwRqHjraT3j5pjJpmmCnr9-PBXcNQ8K-UWgPW810-bo7aVIKSG4-b7Io2rENGTuSBJA2FKLWd6fn1zVt8FsdGTEaecYhqDI85u0YXJ7iTktIKf35AQyeX5Fd2mEqZwh2RtS-Upxglr2droMtqpiiPOOWH0yeWdfJrHlMvz5slgNwVfPNST5tPlxc3iA11eX31cnC2pE0pMVGpuGRtapyQfeuY59tZjB0oMXCpZq4fOWufZSgtrhVS267h3DAdQXrH2pHm_993OqxG9q-tluzHbHEabv5lkg_m7E8MXs053RrdCSt5Xg9MHg5y-zlgmM4bicLOxEdNcDBeaaaFFpyr6-h_0Ns051vMM7xS0LTAmK8X3lMuplIzDYRkGZhew2QdsasDmZ8Dmvope_XnGQfIr0Qq0e6DUVlxj_j37P7Y_AJ96sl8</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2570330116</pqid></control><display><type>article</type><title>Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors</title><source>Springer Nature - Complete Springer Journals</source><creator>Nicolini, Silvia ; Bodei, Lisa ; Bongiovanni, Alberto ; Sansovini, Maddalena ; Grassi, Ilaria ; Ibrahim, Toni ; Monti, Manuela ; Caroli, Paola ; Sarnelli, Anna ; Diano, Danila ; Di Iorio, Valentina ; Grana, Chiara Maria ; Cittanti, Corrado ; Pieri, Federica ; Severi, Stefano ; Paganelli, Giovanni</creator><creatorcontrib>Nicolini, Silvia ; Bodei, Lisa ; Bongiovanni, Alberto ; Sansovini, Maddalena ; Grassi, Ilaria ; Ibrahim, Toni ; Monti, Manuela ; Caroli, Paola ; Sarnelli, Anna ; Diano, Danila ; Di Iorio, Valentina ; Grana, Chiara Maria ; Cittanti, Corrado ; Pieri, Federica ; Severi, Stefano ; Paganelli, Giovanni</creatorcontrib><description>Purpose
FDG-positive neuroendocrine tumors (NETs) have a poorer prognosis and exhibit shorter response duration to peptide receptor radionuclide therapy (PRRT). The aim of this prospective phase II study was to evaluate the efficacy and toxicity of PRRT with
177
Lu-DOTATATE associated with metronomic capecitabine as a radiosensitizer agent in patients with advanced progressive FDG-positive gastro-entero-pancreatic (GEP) NETs.
Patients and methods
Patients with advanced somatostatin receptor- and FDG-positive G1-G3 GEP-NETs (Ki67 < 55%) were treated with a cumulative activity of 27.5 GBq of
177
Lu-DOTATATE divided in five cycles of 5.5 GBq each every 8 weeks. Capecitabine (1000–1500 mg daily) was administered orally in the inter-cycle period between
177
Lu-DOTATATE treatments. Prior to commencing capecitabine, all patients were triaged with the dihydropyrimidine dehydrogenase (DPD) test. Only DPD-proficient individuals were enrolled. The primary objectives were disease control rate (DCR) and safety. Secondary aims included progression-free (PFS) and overall survival (OS). Treatment response was assessed per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1). Toxicity was assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Results
From August 2015 to December 2016, 37 subjects were consecutively enrolled. A total of 25 (68%) were affected by pancreatic neuroendocrine tumors (P-NETs), and 12 (32%) had gastrointestinal neuroendocrine tumors (GI-NETs). By grading (WHO 2010 classification), 12 patients (32%) had G1 (Ki67 ≤ 2%), 22 (59%) had G2 (3% < Ki67 ≤ 20%), and 3 patients (9%) had G3 (Ki67 > 20%) NETs. Grade 3 (G3) or 4 (G4) hematological toxicity occurred in 16.2% of patients. Other G3-G4 adverse events were diarrhea in 5.4% of cases and asthenia in 5.4%. No renal toxicity was observed for the duration of follow-up. In 37 patients, 33 were evaluable for response. Objective responses included partial response (PR) in 10 patients (30%) and stable disease (SD) in 18 patients (55%), with a DCR of 85%. The median follow-up was 38 months (range 4.6–51.1 months). The median PFS was 31.4 months (17.6–45.4), and mOS was not reached.
Conclusions
This study demonstrated that the combination of PRRT with
177
Lu-DOTATATE and metronomic capecitabine is active and well tolerated in patients with aggressive FDG-positive G1-G3 GEP-NETs. These data constitute the basis for a randomized study of PPRT alone vs. PRRT plus metronomic capecitabine.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-021-05236-z</identifier><identifier>PMID: 33604690</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adverse events ; Asthenia ; Cardiology ; Criteria ; Diarrhea ; Disease control ; Evaluation ; Imaging ; Lutetium isotopes ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neuroendocrine tumors ; Nuclear Medicine ; Oncology ; Oncology – General ; Oral administration ; Original Article ; Orthopedics ; Pancreas ; Pancreatic cancer ; Patients ; Radiation therapy ; Radioisotopes ; Radiology ; Receptors ; Solid tumors ; Somatostatin ; Terminology ; Toxicity ; Tumors</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2021-09, Vol.48 (10), p.3260-3267</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-692a11f3c762f81d2e8ade5074f2676074d05aacd1b94aa467a552dc1ef07d713</citedby><cites>FETCH-LOGICAL-c474t-692a11f3c762f81d2e8ade5074f2676074d05aacd1b94aa467a552dc1ef07d713</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-021-05236-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-021-05236-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33604690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nicolini, Silvia</creatorcontrib><creatorcontrib>Bodei, Lisa</creatorcontrib><creatorcontrib>Bongiovanni, Alberto</creatorcontrib><creatorcontrib>Sansovini, Maddalena</creatorcontrib><creatorcontrib>Grassi, Ilaria</creatorcontrib><creatorcontrib>Ibrahim, Toni</creatorcontrib><creatorcontrib>Monti, Manuela</creatorcontrib><creatorcontrib>Caroli, Paola</creatorcontrib><creatorcontrib>Sarnelli, Anna</creatorcontrib><creatorcontrib>Diano, Danila</creatorcontrib><creatorcontrib>Di Iorio, Valentina</creatorcontrib><creatorcontrib>Grana, Chiara Maria</creatorcontrib><creatorcontrib>Cittanti, Corrado</creatorcontrib><creatorcontrib>Pieri, Federica</creatorcontrib><creatorcontrib>Severi, Stefano</creatorcontrib><creatorcontrib>Paganelli, Giovanni</creatorcontrib><title>Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose
FDG-positive neuroendocrine tumors (NETs) have a poorer prognosis and exhibit shorter response duration to peptide receptor radionuclide therapy (PRRT). The aim of this prospective phase II study was to evaluate the efficacy and toxicity of PRRT with
177
Lu-DOTATATE associated with metronomic capecitabine as a radiosensitizer agent in patients with advanced progressive FDG-positive gastro-entero-pancreatic (GEP) NETs.
Patients and methods
Patients with advanced somatostatin receptor- and FDG-positive G1-G3 GEP-NETs (Ki67 < 55%) were treated with a cumulative activity of 27.5 GBq of
177
Lu-DOTATATE divided in five cycles of 5.5 GBq each every 8 weeks. Capecitabine (1000–1500 mg daily) was administered orally in the inter-cycle period between
177
Lu-DOTATATE treatments. Prior to commencing capecitabine, all patients were triaged with the dihydropyrimidine dehydrogenase (DPD) test. Only DPD-proficient individuals were enrolled. The primary objectives were disease control rate (DCR) and safety. Secondary aims included progression-free (PFS) and overall survival (OS). Treatment response was assessed per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1). Toxicity was assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Results
From August 2015 to December 2016, 37 subjects were consecutively enrolled. A total of 25 (68%) were affected by pancreatic neuroendocrine tumors (P-NETs), and 12 (32%) had gastrointestinal neuroendocrine tumors (GI-NETs). By grading (WHO 2010 classification), 12 patients (32%) had G1 (Ki67 ≤ 2%), 22 (59%) had G2 (3% < Ki67 ≤ 20%), and 3 patients (9%) had G3 (Ki67 > 20%) NETs. Grade 3 (G3) or 4 (G4) hematological toxicity occurred in 16.2% of patients. Other G3-G4 adverse events were diarrhea in 5.4% of cases and asthenia in 5.4%. No renal toxicity was observed for the duration of follow-up. In 37 patients, 33 were evaluable for response. Objective responses included partial response (PR) in 10 patients (30%) and stable disease (SD) in 18 patients (55%), with a DCR of 85%. The median follow-up was 38 months (range 4.6–51.1 months). The median PFS was 31.4 months (17.6–45.4), and mOS was not reached.
Conclusions
This study demonstrated that the combination of PRRT with
177
Lu-DOTATATE and metronomic capecitabine is active and well tolerated in patients with aggressive FDG-positive G1-G3 GEP-NETs. These data constitute the basis for a randomized study of PPRT alone vs. PRRT plus metronomic capecitabine.</description><subject>Adverse events</subject><subject>Asthenia</subject><subject>Cardiology</subject><subject>Criteria</subject><subject>Diarrhea</subject><subject>Disease control</subject><subject>Evaluation</subject><subject>Imaging</subject><subject>Lutetium isotopes</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroendocrine tumors</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Oncology – General</subject><subject>Oral administration</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Pancreas</subject><subject>Pancreatic cancer</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Radioisotopes</subject><subject>Radiology</subject><subject>Receptors</subject><subject>Solid tumors</subject><subject>Somatostatin</subject><subject>Terminology</subject><subject>Toxicity</subject><subject>Tumors</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU2LFDEQhhtR3HX1D3iQgJf1EK2k00nnIiyzHwoDe1nBW8gk1WOW6WRMuhfckz_djLOOHwfJoQL1vG9V8TbNSwZvGYB6VwB4pylwRqHjraT3j5pjJpmmCnr9-PBXcNQ8K-UWgPW810-bo7aVIKSG4-b7Io2rENGTuSBJA2FKLWd6fn1zVt8FsdGTEaecYhqDI85u0YXJ7iTktIKf35AQyeX5Fd2mEqZwh2RtS-Upxglr2droMtqpiiPOOWH0yeWdfJrHlMvz5slgNwVfPNST5tPlxc3iA11eX31cnC2pE0pMVGpuGRtapyQfeuY59tZjB0oMXCpZq4fOWufZSgtrhVS267h3DAdQXrH2pHm_993OqxG9q-tluzHbHEabv5lkg_m7E8MXs053RrdCSt5Xg9MHg5y-zlgmM4bicLOxEdNcDBeaaaFFpyr6-h_0Ns051vMM7xS0LTAmK8X3lMuplIzDYRkGZhew2QdsasDmZ8Dmvope_XnGQfIr0Qq0e6DUVlxj_j37P7Y_AJ96sl8</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Nicolini, Silvia</creator><creator>Bodei, Lisa</creator><creator>Bongiovanni, Alberto</creator><creator>Sansovini, Maddalena</creator><creator>Grassi, Ilaria</creator><creator>Ibrahim, Toni</creator><creator>Monti, Manuela</creator><creator>Caroli, Paola</creator><creator>Sarnelli, Anna</creator><creator>Diano, Danila</creator><creator>Di Iorio, Valentina</creator><creator>Grana, Chiara Maria</creator><creator>Cittanti, Corrado</creator><creator>Pieri, Federica</creator><creator>Severi, Stefano</creator><creator>Paganelli, Giovanni</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature 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FDG-positive gastro-entero-pancreatic neuroendocrine tumors</title><author>Nicolini, Silvia ; Bodei, Lisa ; Bongiovanni, Alberto ; Sansovini, Maddalena ; Grassi, Ilaria ; Ibrahim, Toni ; Monti, Manuela ; Caroli, Paola ; Sarnelli, Anna ; Diano, Danila ; Di Iorio, Valentina ; Grana, Chiara Maria ; Cittanti, Corrado ; Pieri, Federica ; Severi, Stefano ; Paganelli, Giovanni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-692a11f3c762f81d2e8ade5074f2676074d05aacd1b94aa467a552dc1ef07d713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adverse events</topic><topic>Asthenia</topic><topic>Cardiology</topic><topic>Criteria</topic><topic>Diarrhea</topic><topic>Disease control</topic><topic>Evaluation</topic><topic>Imaging</topic><topic>Lutetium isotopes</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroendocrine tumors</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Oncology – General</topic><topic>Oral administration</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Pancreas</topic><topic>Pancreatic cancer</topic><topic>Patients</topic><topic>Radiation therapy</topic><topic>Radioisotopes</topic><topic>Radiology</topic><topic>Receptors</topic><topic>Solid tumors</topic><topic>Somatostatin</topic><topic>Terminology</topic><topic>Toxicity</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nicolini, Silvia</creatorcontrib><creatorcontrib>Bodei, Lisa</creatorcontrib><creatorcontrib>Bongiovanni, Alberto</creatorcontrib><creatorcontrib>Sansovini, Maddalena</creatorcontrib><creatorcontrib>Grassi, Ilaria</creatorcontrib><creatorcontrib>Ibrahim, Toni</creatorcontrib><creatorcontrib>Monti, Manuela</creatorcontrib><creatorcontrib>Caroli, Paola</creatorcontrib><creatorcontrib>Sarnelli, Anna</creatorcontrib><creatorcontrib>Diano, Danila</creatorcontrib><creatorcontrib>Di Iorio, Valentina</creatorcontrib><creatorcontrib>Grana, Chiara Maria</creatorcontrib><creatorcontrib>Cittanti, Corrado</creatorcontrib><creatorcontrib>Pieri, Federica</creatorcontrib><creatorcontrib>Severi, Stefano</creatorcontrib><creatorcontrib>Paganelli, Giovanni</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science 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& Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nicolini, Silvia</au><au>Bodei, Lisa</au><au>Bongiovanni, Alberto</au><au>Sansovini, Maddalena</au><au>Grassi, Ilaria</au><au>Ibrahim, Toni</au><au>Monti, Manuela</au><au>Caroli, Paola</au><au>Sarnelli, Anna</au><au>Diano, Danila</au><au>Di Iorio, Valentina</au><au>Grana, Chiara Maria</au><au>Cittanti, Corrado</au><au>Pieri, Federica</au><au>Severi, Stefano</au><au>Paganelli, Giovanni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>48</volume><issue>10</issue><spage>3260</spage><epage>3267</epage><pages>3260-3267</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Purpose
FDG-positive neuroendocrine tumors (NETs) have a poorer prognosis and exhibit shorter response duration to peptide receptor radionuclide therapy (PRRT). The aim of this prospective phase II study was to evaluate the efficacy and toxicity of PRRT with
177
Lu-DOTATATE associated with metronomic capecitabine as a radiosensitizer agent in patients with advanced progressive FDG-positive gastro-entero-pancreatic (GEP) NETs.
Patients and methods
Patients with advanced somatostatin receptor- and FDG-positive G1-G3 GEP-NETs (Ki67 < 55%) were treated with a cumulative activity of 27.5 GBq of
177
Lu-DOTATATE divided in five cycles of 5.5 GBq each every 8 weeks. Capecitabine (1000–1500 mg daily) was administered orally in the inter-cycle period between
177
Lu-DOTATATE treatments. Prior to commencing capecitabine, all patients were triaged with the dihydropyrimidine dehydrogenase (DPD) test. Only DPD-proficient individuals were enrolled. The primary objectives were disease control rate (DCR) and safety. Secondary aims included progression-free (PFS) and overall survival (OS). Treatment response was assessed per Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1). Toxicity was assessed by Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Results
From August 2015 to December 2016, 37 subjects were consecutively enrolled. A total of 25 (68%) were affected by pancreatic neuroendocrine tumors (P-NETs), and 12 (32%) had gastrointestinal neuroendocrine tumors (GI-NETs). By grading (WHO 2010 classification), 12 patients (32%) had G1 (Ki67 ≤ 2%), 22 (59%) had G2 (3% < Ki67 ≤ 20%), and 3 patients (9%) had G3 (Ki67 > 20%) NETs. Grade 3 (G3) or 4 (G4) hematological toxicity occurred in 16.2% of patients. Other G3-G4 adverse events were diarrhea in 5.4% of cases and asthenia in 5.4%. No renal toxicity was observed for the duration of follow-up. In 37 patients, 33 were evaluable for response. Objective responses included partial response (PR) in 10 patients (30%) and stable disease (SD) in 18 patients (55%), with a DCR of 85%. The median follow-up was 38 months (range 4.6–51.1 months). The median PFS was 31.4 months (17.6–45.4), and mOS was not reached.
Conclusions
This study demonstrated that the combination of PRRT with
177
Lu-DOTATATE and metronomic capecitabine is active and well tolerated in patients with aggressive FDG-positive G1-G3 GEP-NETs. These data constitute the basis for a randomized study of PPRT alone vs. PRRT plus metronomic capecitabine.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33604690</pmid><doi>10.1007/s00259-021-05236-z</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1619-7070 |
| ispartof | European journal of nuclear medicine and molecular imaging, 2021-09, Vol.48 (10), p.3260-3267 |
| issn | 1619-7070 1619-7089 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9346628 |
| source | Springer Nature - Complete Springer Journals |
| subjects | Adverse events Asthenia Cardiology Criteria Diarrhea Disease control Evaluation Imaging Lutetium isotopes Medical prognosis Medicine Medicine & Public Health Neuroendocrine tumors Nuclear Medicine Oncology Oncology – General Oral administration Original Article Orthopedics Pancreas Pancreatic cancer Patients Radiation therapy Radioisotopes Radiology Receptors Solid tumors Somatostatin Terminology Toxicity Tumors |
| title | Combined use of 177Lu-DOTATATE and metronomic capecitabine (Lu-X) in FDG-positive gastro-entero-pancreatic neuroendocrine tumors |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T04%3A10%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Combined%20use%20of%20177Lu-DOTATATE%20and%20metronomic%20capecitabine%20(Lu-X)%20in%20FDG-positive%20gastro-entero-pancreatic%20neuroendocrine%20tumors&rft.jtitle=European%20journal%20of%20nuclear%20medicine%20and%20molecular%20imaging&rft.au=Nicolini,%20Silvia&rft.date=2021-09-01&rft.volume=48&rft.issue=10&rft.spage=3260&rft.epage=3267&rft.pages=3260-3267&rft.issn=1619-7070&rft.eissn=1619-7089&rft_id=info:doi/10.1007/s00259-021-05236-z&rft_dat=%3Cproquest_pubme%3E2570330116%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2570330116&rft_id=info:pmid/33604690&rfr_iscdi=true |