Campos Ramírez Sara Elena, Andrés García Alejandro, Blanco Abad Carmen, Gomila Pons Paula, Gómez Mugarza Pablo, Ruffini Egea Sofía Elena, Gallart Caballero Luis, Polo Marques Eduardo, Alonso Orduña Vicente
Department of Medical Oncology, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain.
Department of Nuclear Medicine, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain.
J Clin Med. 2025 Mar 30;14(7):2384. doi: 10.3390/jcm14072384.
Therapy using lutetium-177 dotatate (LU) was approved in Europe for the treatment of advanced neuroendocrine tumors (NETs) in 2017. Since then, it has become part of the strategies in the treatment of NETs, making it now possible to evaluate real-life results. Single-arm, retrospective, multicenter, cohort study of all the patients with metastatic NETs treated with LU (four cycles of 200 mCi every 8 weeks) in the two medical centers dedicated to the treatment of NETs from the region of Aragón, Spain, from 2017 to 2024. Descriptive analysis of demographic characteristics, efficacy, and survival analysis were performed using the statistics software Jamovi 2.6.14. Sixty-eight patients were included. The majority were male, and the most frequent primary location was the pancreas. The ORR was 30.9%. The DCR was 88%. The median OS was 47.4 months [95% CI, 25.6-NE]. The median PFS was 26.1 months [95% CI, 18.5-68.3]. High-grade tumors, multiple previous treatments, and pancreatic location presented worse OS. In total, 42.6% presented any grade adverse event (17.2% hematologic, 30.9% GI symptoms). The efficacy of LU in our study is like that observed in similar studies. Acceptable tolerance has been shown. Pancreatic tumors, previous treatments, and higher grades demonstrated worse outcomes. The new research line must consider the use of treatment with LU in earlier lines for metastatic disease as well as its possible use in local or locally advanced disease.
2017年，镥-177奥曲肽（LU）疗法在欧洲被批准用于治疗晚期神经内分泌肿瘤（NETs）。自那时起，它已成为NETs治疗策略的一部分，现在能够评估实际治疗效果。对2017年至2024年期间在西班牙阿拉贡地区专门治疗NETs的两家医疗中心接受LU治疗（每8周200毫居里，共四个周期）的所有转移性NETs患者进行单臂、回顾性、多中心队列研究。使用统计软件Jamovi 2.6.14对人口统计学特征、疗效进行描述性分析，并进行生存分析。纳入68例患者。大多数为男性，最常见的原发部位是胰腺。客观缓解率（ORR）为30.9%。疾病控制率（DCR）为88%。中位总生存期（OS）为47.4个月[95%置信区间，25.6 - 未估计（NE）]。中位无进展生存期（PFS）为26.1个月[95%置信区间，18.5 - 68.3]。高级别肿瘤、既往多次治疗以及胰腺部位的患者总生存期较差。总共42.6%的患者出现任何级别的不良事件（血液学不良事件占17.2%，胃肠道症状占30.9%）。我们研究中LU的疗效与类似研究中观察到的疗效相似。已显示出可接受的耐受性。胰腺肿瘤、既往治疗以及更高的分级显示出更差的预后。新的研究方向必须考虑在转移性疾病的早期治疗中使用LU治疗，以及其在局部或局部晚期疾病中的可能应用。
