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Peptide receptor radionuclide therapy with 177Lu-octreotate in patients with foregut carcinoid tumours of bronchial, gastric and thymic origin

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Abstract

Purpose

Foregut carcinoid tumours have a different embryological origin than other gastroenteropancreatic neuroendocrine tumours (GEP NETs). In the total group of GEP NETs (n = 131), treatment with 177Lu-octreotate resulted in tumour remission in 47% of patients, with a median time to progression (TTP) of >36 months. As patients with foregut carcinoids may respond differently, we here present the effects of this treatment in a subgroup of patients with foregut carcinoids of bronchial, gastric or thymic origin.

Methods

Nine patients with bronchial, five with gastric and two with thymic carcinoids were treated. All patients had metastasised disease. The intended cumulative dose of 177Lu-octreotate was 22.2–29.6 GBq. Southwest Oncology Group criteria were used for response evaluation.

Results

Bronchial carcinoids: Five patients had partial remission, one had minor response (MR, tumour size reduction: ≥25%, <50%), two had stable disease (SD) and one had progressive disease (PD). Median TTP was 31 months. Gastric carcinoids: One patient had complete remission, one had MR and two had SD, including one with PD at baseline. One patient developed PD. Thymic carcinoids: One patient had SD. In the other patient, disease remained progressive. All patients: Overall remission rate was 50%, including MR.

Conclusion

177Lu-octreotate treatment can be effective in patients with bronchial and gastric carcinoids. Its role in thymic carcinoids cannot be determined yet because of the limited number of patients. The overall remission rate of 50% in patients with the studied foregut carcinoids is comparable to that in the total group of GEP NETs.

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References

  1. Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med 1993;20:716–31.

    Article  CAS  PubMed  Google Scholar 

  2. Williams ED, Sandler M. The classification of carcinoid tumours. Lancet 1963;1:238–9.

    Article  CAS  PubMed  Google Scholar 

  3. Crocetti E, Paci E. Malignant carcinoids in the USA, SEER 1992–1999. An epidemiological study with 6830 cases. Eur J Cancer Prev 2003;12:191–4.

    Article  CAS  PubMed  Google Scholar 

  4. Rindi G, Capella C, Solcia E. Introduction to a revised clinicopathological classification of neuroendocrine tumors of the gastroenteropancreatic tract. Q J Nucl Med 2000;44:13–21.

    CAS  PubMed  Google Scholar 

  5. Brambilla E, Travis WD, Colby TV, Corrin B, Shimosato Y. The new World Health Organization classification of lung tumours. Eur Respir J 2001;18:1059–68.

    Article  CAS  PubMed  Google Scholar 

  6. Skuladottir H, Olsen JH, Hirsch FR. Incidence of lung cancer in Denmark: historical and actual status. Lung Cancer 2000;27:107–18.

    Article  CAS  PubMed  Google Scholar 

  7. Pareja E, Arnau A, Artigues E, Peiro F, Hostalet F, Martin E, et al. Tumores carcinoides bronquiales: un estudio prospectivo. Arch Bronconeumol 1998;34:71–5.

    CAS  PubMed  Google Scholar 

  8. Soga J, Yakuwa Y. Bronchopulmonary carcinoids: an analysis of 1,875 reported cases with special reference to a comparison between typical carcinoids and atypical varieties. Ann Thorac Cardiovasc Surg 1999;5:211–9.

    CAS  PubMed  Google Scholar 

  9. Rindi G, Luinetti O, Cornaggia M, Capella C, Solcia E. Three subtypes of gastric argyrophil carcinoid and the gastric neuroendocrine carcinoma: a clinicopathologic study. Gastroenterology 1993;104:994–1006.

    CAS  PubMed  Google Scholar 

  10. Mulkeen A, Cha C. Gastric carcinoid. Curr Opin Oncol 2005;17:1–6.

    Article  PubMed  Google Scholar 

  11. Delle Fave G, Capurso G, Milione M, Panzuto F. Endocrine tumours of the stomach. Best Pract Res Clin Gastroenterol 2005;19:659–73.

    Article  CAS  PubMed  Google Scholar 

  12. Soga J, Yakuwa Y, Osaka M. Evaluation of 342 cases of mediastinal/thymic carcinoids collected from literature: a comparative study between typical carcinoids and atypical varieties. Ann Thorac Cardiovasc Surg 1999;5:285–92.

    CAS  PubMed  Google Scholar 

  13. Fukai I, Masaoka A, Fujii Y, Yamakawa Y, Yokoyama T, Murase T, et al. Thymic neuroendocrine tumor (thymic carcinoid): a clinicopathologic study in 15 patients. Ann Thorac Surg 1999;67:208–11.

    Article  CAS  PubMed  Google Scholar 

  14. Kwekkeboom DJ, Teunissen JJ, Bakker WH, Kooij PP, de Herder WW, Feelders RA, et al. Radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors. J Clin Oncol 2005;23:2754–62.

    Article  CAS  PubMed  Google Scholar 

  15. Kwekkeboom DJ, Bakker WH, Kooij PP, Konijnenberg MW, Srinivasan A, Erion JL, et al. [177Lu-DOTA0Tyr3]octreotate: comparison with [111In-DTPA0]octreotide in patients. Eur J Nucl Med 2001;28:1319–25.

    Article  CAS  PubMed  Google Scholar 

  16. Green S, Weiss GR. Southwest Oncology Group standard response criteria, endpoint definitions and toxicity criteria. Invest New Drugs 1992;10:239–53.

    Article  CAS  PubMed  Google Scholar 

  17. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer 2003;97:934–59.

    Article  PubMed  Google Scholar 

  18. Papotti M, Croce S, Macri L, Funaro A, Pecchioni C, Schindler M, et al. Correlative immunohistochemical and reverse transcriptase polymerase chain reaction analysis of somatostatin receptor type 2 in neuroendocrine tumors of the lung. Diagn Mol Pathol 2000;9:47–57.

    Article  CAS  PubMed  Google Scholar 

  19. Granberg D, Eriksson B, Wilander E, Grimfjard P, Fjallskog ML, Oberg K, et al. Experience in treatment of metastatic pulmonary carcinoid tumors. Ann Oncol 2001;12:1383–91.

    Article  CAS  PubMed  Google Scholar 

  20. Teunissen JJ, Kwekkeboom DJ, de Jong M, Esser JP, Valkema R, Krenning EP. Endocrine tumours of the gastrointestinal tract. Peptide receptor radionuclide therapy. Best Pract Res Clin Gastroenterol 2005;19:595–616.

    Article  CAS  PubMed  Google Scholar 

  21. De Jong M, Breeman WA, Valkema R, Bernard BF, Krenning EP. Combination radionuclide therapy using 177Lu- and 90Y-labeled somatostatin analogs. J Nucl Med 2005;46 Suppl 1:13S–7S.

    Google Scholar 

  22. Otte A, Herrmann R, Heppeler A, Behe M, Jermann E, Powell P, et al. Yttrium-90 DOTATOC: first clinical results. Eur J Nucl Med 1999;26:1439–47.

    Article  CAS  PubMed  Google Scholar 

  23. Waldherr C, Pless M, Maecke HR, Haldemann A, Mueller-Brand J. The clinical value of [90Y-DOTA]-D-Phe1-Tyr3-octreotide (90Y-DOTATOC) in the treatment of neuroendocrine tumours: a clinical phase II study. Ann Oncol 2001;12:941–5.

    Article  CAS  PubMed  Google Scholar 

  24. Waldherr C, Pless M, Maecke HR, Schumacher T, Crazzolara A, Nitzsche EU, et al. Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq 90Y-DOTATOC. J Nucl Med 2002;43:610–6.

    CAS  PubMed  Google Scholar 

  25. Bodei L, Cremonesi M, Zoboli S, Grana C, Bartolomei M, Rocca P, et al. Receptor-mediated radionuclide therapy with 90Y-DOTATOC in association with amino acid infusion: a phase I study. Eur J Nucl Med Mol Imaging 2003;30:207–16.

    Article  CAS  PubMed  Google Scholar 

  26. Valkema R, Pauwels S, Kvols LK, Barone R, Jamar F, Bakker WH, et al. Survival and response after peptide receptor radionuclide therapy with [90Y-DOTA0,Tyr3]octreotide in patients with advanced gastroenteropancreatic neuroendocrine tumors. Semin Nucl Med 2006;36:147–56.

    Article  PubMed  Google Scholar 

  27. Anthony LB, Woltering EA, Espanan GD, Cronin MD, Maloney TJ, McCarthy KE. Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies. Semin Nucl Med 2002;32:123–32.

    Article  PubMed  Google Scholar 

  28. Valkema R, De Jong M, Bakker WH, Breeman WA, Kooij PP, Lugtenburg PJ, et al. Phase I study of peptide receptor radionuclide therapy with [111In-DTPA0]octreotide: the Rotterdam experience. Semin Nucl Med 2002;32:110–22.

    Article  PubMed  Google Scholar 

  29. Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1–SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 2000;27:273–82.

    Article  CAS  PubMed  Google Scholar 

  30. Reubi JC, Waser B, Schaer JC, Laissue JA. Somatostatin receptor sst1–sst5 expression in normal and neoplastic human tissues using receptor autoradiography with subtype-selective ligands. Eur J Nucl Med 2001;28:836–46.

    Article  CAS  PubMed  Google Scholar 

  31. Kwekkeboom DJ, Mueller-Brand J, Paganelli G, Anthony LB, Pauwels S, Kvols LK, et al. Overview of results of peptide receptor radionuclide therapy with 3 radiolabeled somatostatin analogs. J Nucl Med 2005;46:62S–6S.

    CAS  PubMed  Google Scholar 

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Correspondence to Martijn van Essen.

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van Essen, M., Krenning, E.P., Bakker, W.H. et al. Peptide receptor radionuclide therapy with 177Lu-octreotate in patients with foregut carcinoid tumours of bronchial, gastric and thymic origin. Eur J Nucl Med Mol Imaging 34, 1219–1227 (2007). https://doi.org/10.1007/s00259-006-0355-4

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  • DOI: https://doi.org/10.1007/s00259-006-0355-4

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