Marretta Antonella Lucia, Ottaiano Alessandro, Iervolino Domenico, Bracigliano Alessandra, Clemente Ottavia, Di Gennaro Francesca, Tafuto Roberto, Santorsola Mariachiara, Lastoria Secondo, Tafuto Salvatore
Department of Clinical and Surgery Oncology Unit, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy.
SSD Innovative Therapies for Abdominal Metastases, Department of Abdominal Oncology, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Via M. Semmola, 80131 Naples, Italy.
J Clin Med. 2023 Feb 13;12(4):1494. doi: 10.3390/jcm12041494.
Peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE and 90Y-DOTATOC showed efficacy in the metastatic setting of pheocromocytomas (PCCs) and paragangliomas (PGLs) where no standard therapies have been established.
A search of peer-reviewed and English articles reporting on 177Lu-DOTATATE and 90Y-DOTATOC efficacy was performed through Medline and Scopus. A subsequent meta-analysis was performed to evaluate the pooled effect size on disease control rate (DCR) with PRRT. Secondary endpoints were description of patients' genetic characteristics, hematologic toxicity, and time-to-outcome. The pooled effect was estimated with both a mixed-effects model and a random-effects model.
Twelve studies met the criteria for this meta-analysis: ten with 177Lu- and two with 90Y-PRRTs (213 patients). The largest one included 46 patients. Median ages ranged from 32.5 to 60.4 years. When reported, mutations of SDHB were the most frequent genetic alterations. The pooled DCRs were 0.83 (95% CI: 0.75-0.88) and 0.76 (95% CI: 0.56-0.89) for 177Lu- and 90Y-PRRT, respectively. The pooled DCR for PRRT was 0.81 (95% CI: 0.74-0.87).
We report an updated and solid estimate of DCR achieved with 177Lu- and 90Y-PRRT in PCCs and PGLs, showing that these therapies can be considered in the multidisciplinary treatment of PCCs and PGLs as alternatives to I-131 MIBG and chemotherapy.
使用177镥-奥曲肽和90钇-奥曲肽的肽受体放射性核素治疗（PRRT）在未确立标准治疗方法的嗜铬细胞瘤（PCCs）和副神经节瘤（PGLs）转移情况下显示出疗效。
通过Medline和Scopus检索了报道177镥-奥曲肽和90钇-奥曲肽疗效的同行评审英文文章。随后进行了一项荟萃分析，以评估PRRT对疾病控制率（DCR）的合并效应量。次要终点是患者遗传特征、血液学毒性和至结局时间的描述。使用混合效应模型和随机效应模型估计合并效应。
12项研究符合该荟萃分析的标准：10项使用177镥-PRRT，2项使用90钇-PRRT（213例患者）。最大的一项研究包括46例患者。中位年龄范围为32.5至60.4岁。当有报道时，SDHB突变是最常见的基因改变。177镥-PRRT和90钇-PRRT的合并DCR分别为0.83（95%CI：0.75 - 0.88）和0.76（95%CI：0.56 - 0.89）。PRRT的合并DCR为0.81（95%CI：0.74 - 0.87）。
我们报告了177镥-PRRT和90钇-PRRT在PCCs和PGLs中实现的DCR的最新可靠估计，表明这些疗法可作为131碘-间碘苄胍和化疗的替代方案，用于PCCs和PGLs的多学科治疗。
