Annals of Oncology 10:S23-S29, 1999
© 1999 European Society for Medical Oncology
Symposium Articles |
Radiolabelled somatostatin analogue(s) for peptide receptor scintigraphy and radionuclide therapy
1 Department of Nuclear Medicine, University Hospital and Erasmus University Rotterdam (EUR) The Netherlands
2 Department of Internal Medicine III, University Hospital and Erasmus University Rotterdam (EUR) The Netherlands
3 Surgery, University Hospital and Erasmus University Rotterdam (EUR) The Netherlands
4 Department of Nuclear Medicine, Catholic University of Louvain Brussels, Belgium
Correspondence to: E. P. Krenning, MD, PhD Department of Nuclear Medicine, University Hospital Rotterdam, 3015 GD Rotterdam, The Netherlands E-mail: krenning{at}nuge.azr.nl
Background: Peptide receptor scintigraphy with the radioactive somatostatin analogue, [111In-DTPA0]octreotide, is a sensitive and specific technique to show in vivo the presence and abundance of somatostatin receptors on various tumours.
Aim: With this technique primary tumours and metastases of neuroendocrine cancers as well as of many other cancer-types can be localised. This technique is currently used to assess the possibility of peptide receptor radionuclide therapy (PRRT) with repeated administrations of high doses of [111In-DTPA0]octreotide. 111In emits Auger and conversion electrons having a tissue penetration of 0.02–10 µm and 200 to 500 µm, respectively.
Patients and methods: Thirty end-stage patients with mostly neuroendocrine progressing tumours were treated with [111In-DTPA0]octreotide, up to a maximal cumulative patient dose of about 74 GBq, in a phase I trial.
Results: There were no major clinical side effects after up to two years treatment, except that in a few patients a transient decline in platelets counts and lymphocyte subsets occurred. Promising beneficial effects on clinical symptoms, hormone production and tumour proliferation were found. Of the 21 patients who received a cumulative dose of more than 20 GBq, eight patients showed stabilisation of disease and six other patients a reduction in size of tumours. There is a tendency towards better results in patients whose tumours have a higher accumulation of the radioligand.
Conclusions: PRRT is feasible, also with 111In as radionuclide. Depending on the homogeneity of distribution of tumour cells expressing peptide receptors and the size of the tumour, β-emitting radionuclides, e.g., 90Y, labelled to DOTA-chelated peptides, are also attractive candidates for PRRT. The first PRRT trials with [90Y-DOTA0,Tyr3]octreotide started recently.
octreotide, peptide, radionuclide, scintigraphy, somatostatin, therapy
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