Table 4.
Cases of aggressive pituitary neuroendocrine tumors and pituitary carcinomas treated with peptide receptor radionuclide therapy (PRRT).
| Ref. | Sex and Age at Diagnosis | Tumor Type | Carcinoma | Previous Treatments | Treatment, Number of Cycles (cumulative dose/activity) | Response | Adverse Effects |
|---|---|---|---|---|---|---|---|
| [60] | Female, 16y | Functioning corticotroph | Yes | 2 NS, RT, 4 NS, RT, NS, bilateral adrenalectomy, NS, RT | 90Y-DOTATOC, 2 cycles (200mCi) | NA, but the patient died of elevated intracranial pressure shortly after | NA |
| [61] | Male, 56y | NIR | No | NS, RT | 177Lu-DOTATOC, 3 cycles (600 mCi) | TV: SD ** | NA |
| [62] | Male, 40y | NF * | Yes | NS, RT, NS, surgery for metastasis | 177Lu-DOTATATE, 4 cycles (~30 MBq) | TV: CR in some nodules, and overall SD at 40 months ** | Transient thrombocytopenia |
| [62] | Male, 39y | Functioning somato-lactotroph | No | NS, RT, LAN, CAB, 4 NS with gliadel wafers in 2, TMZ, RT | 177Lu-DOTATATE, 2 cycles (15.3 Mbq) | TV: PD ** (the patient died 2 months after PRRT was started—deterioration of brainstem disease) HS: NA |
NA |
| [62] | Male, 26y | Silent corticotroph | No | 2 NS, RT, NS, TMZ, TMZ, NS | 177Lu-DOTATATE, 1 cycle | TV: PD ** | Severe increase in the facial pain |
| [63] | Male, 59y | NF * | No | 3 NS, RT, SSA, TMZ | 177Lu-DOTATATE * | TV: NA, but the patient died in the following months | NA |
| [63] | Male, 46y | Functioning somatotroph | Yes | 6 NS, RT, SSA/PEG, TMZ, palliative RT | 90Y-DOTATATE * | No effect ** | NA |
| [64] | Male, 23y | Functioning somatotroph | No | SSA, NS, SSA, RT | 90Y-DOTATATE, 4 cycles (400mCi) | TV: PR at 12 months HS: PR at 12 months |
Transient anemia and leucopenia |
| [4] | NA | NA | NA | TMZ * | DOTATOC * | No effect ** | NA |
| [4] | NA | NA | NA | TMZ * | DOTATOC * | Ongoing * | NA |
| [3] | NA | NA | No | No previous TMZ * | As first-line therapy * | PR * | NA |
| [3] | NA | NA | No | No previous TMZ * | As first-line therapy * | SD * | NA |
| [3] | NA | NA | NA | TMZ * | As second- or third-line therapy * | PD * | NA |
| [3] | NA | NA | NA | TMZ * | As second- or third-line therapy * | PD * | NA |
| [3] | NA | NA | NA | TMZ * | As second- or third-line therapy * | PD * | NA |
| [3] | NA | NA | NA | TMZ * | As second- or third-line therapy * | PD * | NA |
| [3] | NA | NA | NA | TMZ * | As second- or third-line therapy * | PD * | NA |
| [65,66,67] | Female, 58y | Functioning lactotroph | No | BCT, NS, CAB, RT | 111In-octreotide, 5 cycles (37 GBq) + CAB 0.5 mg daily | TV: PR after the first 2 cycles, further PR after the next 2 cycles, and further PR after the last cycle HS: PR |
None |
| [65,66] | Male, 54y | Functioning lactotroph | No | CAB, 3 NS, RT, TMZ | 177Lu-DOTATOC, 2 cycles (12.6 GBq) | TV: PD HS: Good biochemical control ** |
None |
| [65,66] | Female, 53y | NF * | No | 5 NS, RT, TMZ | 177Lu-DOTATOC, 5 cycles (29.8 GBq) | TV: PD | None |
Reference (Ref.), years (y), neurosurgery (NS), radiotherapy (RT), 90Yttrium-DOTATOC (90Y-DOTATOC), not available (NA), non-immunoreactive (NIR), 177Lutetium-DOTATOC (177Lu-DOTATOC), tumor volume (TV), stable disease (SD), non-functioning (NF), 177Lutetium-DOTATATE (177Lu-DOTATATE), complete response (CR), lanreotide (LAR), cabergoline (CAB), bromocriptine (BCT), temozolomide (TMZ), progressive disease (PD), somatostatin analogues (SSA), pegvisomant (PEG), 90Yttrium-DOTATATE (90Y-DOTATATE), 111Indium-DTPA-octreotide (111In-octreotide), hormonal secretion (HS), partial response (PR); * no further information available, ** as assessed by the authors (the percentage by which the tumor increased or decreased not reported and/or hormone levels not reported).