Table 2.
Case number | Primary site, MIB-1 index | Prior therapies | Size of lesions (largest diameter) | Indication for sequential duo-PRRT | Cumulative dose and cycles of 177Lu-DOTATATE PRRT | Dose of 90Y-DOTATATE PRRT | Adverse effects | Follow-up period after sequential duo-PRRT |
---|---|---|---|---|---|---|---|---|
I | Mediastinal NET, 30% | Surgical resection of primary lesion, Somatostatin analog therapy and external beam radiotherapy | 12 cm | Stable, unresponsive disease following 177Lu-DOTATATE | 33.3 GBq, 5 cycles | 2.7 GBq - First cycle | No | 105 days |
II | Pancreatic NET, 2% | Somatostatin analog therapy | 8 cm | Progressive disease after 177Lu-DOTATATE | 25.23 GBq, 4 cycles | 2.8GBq-First cycle, 3.3 GBqsecond cycle | No | 135 days |
III | Duodenal NET, 10% | No prior therapies | 10 cm | Stable, unresponsive disease following 177Lu-DOTATATE | 31.59 GBq, 5 cycles | 2.66 GBq - First cycle | No | 135 days |
IV | Pancreatic NET, 10 % | Surgical resection of primary lesion, somatostatin analog therapy | 5.5 cm | Stable, unresponsive disease following 177Lu-DOTATATE | 37 GBq, 6 cycles | 3.14 GBq - First cycle | Transient mild-grade hemoglobin toxicity | 105 days |
V | Rectal NET, 12% | Somatostatin analog therapy | 13 cm | Progressive disease after 177Lu-DOTATATE | 22.2 GBq, 4 cycles | 3.4 GBq- First cycle | Mild-grade of nausea | 75 days |
VI | Pancreatic NET, 1% | No prior therapies | 5.5cm | Neoadjuvant intent | 14.8 GBq, 2 cycles | 3.25 GBq - First cycle | Mild-grade of nausea and gastrointestinal symptoms | 75 days |
VII | Pancreatic NET, 1% | Somatostatin analog therapy | 7 cm | Stable, unresponsive disease following 177Lu-DOTATATE | 32 GBq, 5 cycles | 3.4 GBq - First cycle | No | 60 days |
VIII | Unknown primary site, 8% | No | 13 cm | Stable, unresponsive disease following 177Lu-DOTATATE | 37 GBq, 6 cycles | 3.4 GBq - First cycle | No | 30 days |
IX | Duodenal NET, 8% | Surgical resection of primary lesion | 16 cm | Neoadjuvant intent | 11.84 GBq, 2 cycles | 3.4GBq- First cycle | No | 15 days |
PRRT: Peptide receptor radionuclide therapy; NET: Neuroendocrine tumor; MIB: antibody directed at the protein Ki-67