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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

Open Access 01-08-2017 | Original Article

Individualised ¹⁷⁷Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry

Authors: Anna Sundlöv, Katarina Sjögreen-Gleisner, Johanna Svensson, Michael Ljungberg, Tomas Olsson, Peter Bernhardt, Jan Tennvall

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2017

Abstract

Purpose

To present data from an interim analysis of a Phase II trial designed to determine the feasibility, safety, and efficacy of individualising treatment based on renal dosimetry, by giving as many cycles as possible within a maximum renal biologically effective dose (BED).

Method

Treatment was given with repeated cycles of 7.4 GBq ¹⁷⁷Lu-DOTATATE at 8-12-week intervals. Detailed dosimetry was performed in all patients after each cycle using a hybrid method (SPECT + planar imaging). All patients received treatment up to a renal BED of 27 ± 2 Gy (α/β = 2.6 Gy) (Step 1). Selected patients were offered further treatment up to a renal BED of 40 ± 2 Gy (Step 2). Renal function was followed by estimation and measurement of the glomerular filtration rate (GFR).

Results

Fifty-one patients were included in the present analysis. Among the patients who received treatment as planned, the median number of cycles in Step 1 was 5 (range 3-7), and for those who completed Step 2 it was 7 (range 5-8); 73% were able to receive >4 cycles. Although GFR decreased in most patients after the completion of treatment, no grade 3-4 toxicity was observed. Patients with a reduced baseline GFR seemed to have an increased risk of GFR decline. Five patients received treatment in Step 2, none of whom exhibited a significant reduction in renal function.

Conclusions

Individualising PRRT using renal dosimetry seems feasible and safe and leads to an increased number of cycles in the majority of patients. The trial will continue as planned.

Available only for authorised users

If not otherwise specified, an α/β value of 2.6 Gy has been used for the BED-calculations.

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Title: Individualised 177Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry
Authors: Anna Sundlöv
Katarina Sjögreen-Gleisner
Johanna Svensson
Michael Ljungberg
Tomas Olsson
Peter Bernhardt
Jan Tennvall
Publication date: 01-08-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3678-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Individualised ¹⁷⁷Lu-DOTATATE treatment of neuroendocrine tumours based on kidney dosimetry

Abstract

Purpose

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Method

Results

Conclusions

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