Digestive Disease Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy.
Nuclear Medicine Unit, Sant'Andrea University Hospital, ENETS Center of Excellence, Rome, Italy.
Oncol Res Treat. 2021;44(5):276-280. doi: 10.1159/000515859. Epub 2021 Apr 14.
The efficacy of 177Lu-Dotatate was shown in the NETTER-1 trial, an international, open-label, multicentre phase III clinical trial that evaluated the safety and efficacy of 177Lu-Dotatate in patients with well-differentiated, advanced midgut neuroendocrine tumours (NETs) with evidence of disease progression. Recently, retreatment with peptide receptor radionuclide therapy (PRRT) has been proposed as a valid therapeutic option in patients without other effective options who had responded to initial PRRT; however, data on this therapeutic option are still inadequate.
In this report, we present the case of a patient who achieved a delayed complete radiological response after initial 177Lu-Dotatate treatment and who had a complete tumour response with PRRT retreatment 5 years later.
This case report shows that, although rare, a complete, prolonged tumour response may occur in patients with advanced small-bowel NETs receiving PRRT. Retreatment with PRRT may be a valid option in cases of subsequent disease recurrence.
在 NETTER-1 试验中已证实 177Lu-Dotatate 的疗效，这是一项国际性、开放性、多中心的 III 期临床试验，评估了 177Lu-Dotatate 在有疾病进展证据的分化良好、晚期中肠神经内分泌肿瘤（NET）患者中的安全性和疗效。最近，肽受体放射性核素治疗（PRRT）的再次治疗被提议作为对初始 PRRT 有反应且无其他有效选择的患者的有效治疗选择；然而，关于这种治疗选择的数据仍然不足。
在本报告中，我们报告了一例患者，其在初始 177Lu-Dotatate 治疗后出现延迟完全的影像学反应，并且在 5 年后接受 PRRT 再次治疗后出现完全肿瘤反应。
本病例报告表明，尽管罕见，但接受 PRRT 的晚期小肠 NET 患者可能会出现完全、持久的肿瘤反应。在随后的疾病复发时，PRRT 的再次治疗可能是一种有效的选择。
