To assess the safety, tolerability and efficacy of intra arterial Lu-177 DOTA TATE therapy in 4 patients with liver dominant metastasis in well differentiated Neuro endocrine metastases.
Methods and materials
Four patients with well differentiated NET liver dominant metastasis
4 cycles of 200mCi of Lu-177 DOTATATE therapy intra arterially at interval of 8 weeks
Through selective hepatic arterial catheterization.
All patients received bilobar hepatic arterial infusions in the same sitting.
All patients were administered aminoacid infusions for 4-6 hours starting pretherapy and continued post therapy infusions for nephroprotection.
Plan to cover with long acting octeotide therapy was instituted in case of endocrine crisis.
Their complete blood counts, liver function, renal function and coagulation profiles were...
Significant reduction in serum chromogranin A levels
Partial reduction in size and tracer uptake in all patients were noted.
None of the patients experienced any acute side effects or unexpected complication during therapy or in the immediate post therapy period .
No RILD or renal toxicity seen during the course of therapy and even after the last cycle.
Liver functions remained stable with improved quality of life.
Three patients showed partial response. One patient showed stable disease (PERCIST)
Survival benefits will be evaluated after 1 year of follow up.
Personal information and conflict of interest
S. Kalmath; Chennai, TR/IN - nothing to disclose A. Rajan; Chennai/IN - nothing to disclose M. C. Uthappa; Bengaluru/IN - nothing to disclose J. Kalyanaraman; Chennai/IN - nothing to disclose A. S. Reddy; Guntur/IN - nothing to disclose
Brabander T, van der Zan WA, Teunissen JJM, et al. Long-term efficacy, survival, and safety of [177Lu-DOTA0,Tyr3]octreotate in patients with gastroenteropancreatic and bronchial neuroendocrine tumors. Clin Cancer Res. 2017;23:4617-4624.
National Comprehensive Cancer Network®. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Neuroendocrine and Adrenal Tumors (Version 2.2018) website. https://www.nccn.org/professionals/physician_gls/default.aspx
Abbott A, Kuzuhara Y, Jacene H, et al. 177Lu-dotatate therapy for patients with metastatic gastrointestinal neuroendocrine tumors: How to prepare your practice for optimal administration. J Nucl Med 2016;57:2681
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