Dados do Trabalho

Título

TREATMENT WITH DOTATATO-177LU: A MULTICENTRIC EXPERIENCE IN BRAZIL

Introdução

Peptide receptor radionuclide therapy (PRRT) with Dotatate-177Lu is a treatment modality for neuroendocrine tumors (NET) of the gastroenteropancreatic tract (GEPNET). Whereas PPRT has received approval in this context by various regulatory agencies worldwide, its utility may not be not restricted to these tumors alone and could represent a viable alternative in other tumors with expression of somatostatin receptors.

Objetivo

In this study we present real world data on the use of PRRT in different Brazilian nuclear medicine services that corroborate its effectiveness in GEPNETs and reinforce the possibility of using this therapeutic modality in other tumors with neuroendocrine differentiation.

Método

A retrospective analysis was performed of patients with NET and other tumors with significant expression of somatostatin receptors, from 4 different nuclear medicine services in different Brazilian capitals, who underwent PRRT with Dotatato-177Lu, between January 2007 and April 2021. Demographic data, as well as efficacy, survival and toxicity outcomes were analyzed within each institution by multidisciplinary teams.

Resultado

One hundred and sixty-four patients (86 females - 52.4%) with disease progression received between 1 and 8 applications of Dotatate-177Lu (median of 4). Primary tumors were classified as midgut (34.8%), pancreatic (24.4%), foregut (14.6%), hindgut (4.9%), unknown site (CUP-NET - 6.1%) and other (15.2%). Ninety-eight patients completed follow-up with a median progression-free survival of approximately 12 months. A total of 30 patients died during the observation period, 4 patients achieved a complete response and another 2 were able to undergo complete resection of the remaining tumor after PRRT.

Conclusão

This is the largest Brazilian series of patients treated with Dotatate-177Lu. In the services evaluated, the use of PRRT was observed in a significant number of patients with non-GEPNET NET, in addition to other non-neuroendocrine tumors with expression of somatostatin receptors. The median progression-free survival was considerably lower than that observed in the NETTER-1 study, possibly due to the inclusion of patients with non-GEPNET NET and other tumors with neuroendocrine differentiation that often possess a worse prognosis. Despite this, PRRT represented a safe option, with good response rates and low treatment-related toxicity.

Palavras-chave

neuroendocrine tumors, Dotatate-177Lu, nuclear medicine