Peptide receptor radionuclide therapy (PRRT) for GEP-NETs

Best Pract Res Clin Gastroenterol. 2012 Dec;26(6):867-81.
Bergsma H, van Vliet EI, Teunissen JJ, Kam BL, de Herder WW, Peeters RP, Krenning EP, Kwekkeboom DJ.
Best Pract Res Clin Gastroenterol. 2012 Dec;26(6):867-81.
La terapia del recettore del peptide radionuclide (PRRT), con 90Y-DOTATOC e 177Lu-DOTATATE, potrebbe diventare la terapia di prima linea nei pazienti con tumori neuroendocrini gastro-entero-pancreatici (GEP-NET) metastatizzati o inoperabili.
90Y-DOTATOC e 177Lu-DOTATATE/tumori neuroendocrini gastro-entero-pancreatici.

Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues plays an increasing role in the treatment of patients with inoperable or metastasised gatroenteropancreatic neuroendocrine tumours (GEP-NETs). (90)Y-DOTATOC and (177)Lu-DOTATATE are the most used radiopeptides for PRRT with comparable tumour response rates (about 15-35%). The side effects of this therapy are few and mild. However, amino acids should be used for kidney protection, especially during infusion of (90)Y-DOTATOC. Options to improve PRRT may include combinations of radioactive labelled somatostatin analogues and the use of radiosensitising drugs combined with PRRT. Other therapeutic applications of PRRT may include intra-arterial administration, neo-adjuvant treatment and additional PRRT cycles in patients with progressive disease, who have benefited from initial therapy. Considering the mild side-effects, PRRT may well become the first-line therapy in patients with metastasised or inoperable GEP-NETs if more widespread use of PRRT can be accomplished.