PDF herunterladen
Open Access
CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(04): 329-335
DOI: 10.4103/wjnm.wjnm_160_20
Review Article

Targeted alpha-particle therapy in neuroendocrine neoplasms: A systematic review

Autor*innen

  • Thuan Koh

    1   Department of Nuclear Medicine and Radiology, Flinders Medical Center, Bedford Park, Sydney, New South Wales, Australia

  • Eva Bezak

    2   Centre for Translational Cancer Research, University of South Australia Cancer Research Institute, Adelaide, Australia

  • David Chan

    3   Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia

  • Gabrielle Cehic

    1   Department of Nuclear Medicine and Radiology, Flinders Medical Center, Bedford Park, Sydney, New South Wales, Australia
    2   Centre for Translational Cancer Research, University of South Australia Cancer Research Institute, Adelaide, Australia
    4   Department of Nuclear Medicine and Radiology, Flinders Medical Center, Bedford Park; Centre for Translational Cancer Research, University of South Australia Cancer Research Institute, Adelaide; Department of Nuclear Medicine, The Queen Elizabeth Hospital, Woodville, SA, Australia
Weitere Informationen
Auch verfügbar auf
  Lizenzen und Reprints

Abstract

Neuroendocrine neoplasms (NENs) are a very diverse group of tumors with a worldwide rise in incidence. Systemic therapy remains the mainstay treatment for unresectable and/or metastatic NENs. 177Lu-DOTATATE, a radiopharmaceutical which emits beta particles, has emerged as a promising therapy for metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, limited treatment options are available particularly after the failure of 177Lu-DOTATATE therapy. This review aims to identify and summarize the available evidence for, and potential adverse events of, targeted alpha-particle therapy (TAT) in the treatment of metastatic NENs, specifically GEP-NENs. The MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases were searched. Two articles which met the inclusion criteria were identified and included in the review. Putative radiopharmaceuticals that can be considered for metastatic NEN treatment include 225Actinium (225Ac)-DOTATATE and 213Bismuth (213Bi)-DOTATOC. There was evidence of partial response using both radiopharmaceutical agents without significant hematological, renal, or hepatotoxicity. Future studies should consider longer term, randomized controlled trials investigating the role of TAT, in particular, 225Ac-DOTATATE, in the treatment of metastatic NENs.

Keywords

213Bismuth - 225Actinium - endocrine - neuroendocrine neoplasms - oncology - radionuclide therapy - radionuclide therapy - targeted alpha therapy

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 23. Februar 2021

Angenommen: 07. März 2021

Artikel online veröffentlicht:
24. März 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Taal BG, Visser O. Epidemiology of neuroendocrine tumours. Neuroendocrinology 2004;80 Suppl 1:3-7.
  • 2 Dasari A, Shen C, Halperin D, Zhao B, Zhou S, Xu Y, et al. Trends in the incidence, prevalence, and survival outcomes in patients with neuroendocrine tumors in the United States. JAMA Oncol 2017;3:1335-42.
  • 3 Australian Institute of Health and Welfare. (2020). Neuroendocrine tumours statistics 2020. https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/contents/summary
  • 4 Gulenchyn KY, Yao X, Asa SL, Singh S, Law C. Radionuclide therapy in neuroendocrine tumours: A systematic review. Clin Oncol (R Coll Radiol) 2012;24:294-308.
  • 5 Carlsen EA, Fazio N, Granberg D, Grozinsky-Glasberg S, Ahmadzadehfar H, Grana CM, et al. Peptide receptor radionuclide therapy in gastroenteropancreatic NEN G3: A multicenter cohort study. Endocr Relat Cancer 2019;26:227-39.
  • 6 Oronsky B, Ma PC, Morgensztern D, Carter CA. Nothing but NET: A review of neuroendocrine tumors and carcinomas. Neoplasia 2017;19:991-1002.
  • 7 Rinke A, Müller HH, Schade-Brittinger C, Klose KJ, Barth P, Wied M, et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: A report from the PROMID Study Group. J Clin Oncol 2009;27:4656-63.
  • 8 Caplin ME, Pavel M, Ćwikła JB, Phan AT, Raderer M, Sedláčková E, et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med 2014;371:224-33.
  • 9 Stueven AK, Kayser A, Wetz C, Amthauer H, Wree A, Tacke F, et al. Somatostatin Analogues in the Treatment of Neuroendocrine Tumors: Past, Present and Future. Int J Mol Sci. 2019;20:3049.
  • 10 Valkema R, De Jong M, Bakker WH, Breeman WA, Kooij PP, Lugtenburg PJ, et al. Phase I study of peptide receptor radionuclide therapy with [In-DTPA] octreotide: The Rotterdam experience. Semin Nucl Med 2002;32:110-22.
  • 11 Bushnell DL Jr., O'Dorisio TM, O'Dorisio MS, Menda Y, Hicks RJ, Van Cutsem E, et al. 90Y-edotreotide for metastatic carcinoid refractory to octreotide. J Clin Oncol 2010;28:1652-9.
  • 12 Imhof A, Brunner P, Marincek N, Briel M, Schindler C, Rasch H, et al. Response, survival, and long-term toxicity after therapy with the radiolabeled somatostatin analogue [90Y-DOTA]-TOC in metastasized neuroendocrine cancers. J Clin Oncol 2011;29:2416-23.
  • 13 Kwekkeboom DJ, de Herder WW, Kam BL, van Eijck CH, van Essen M, Kooij PP, et al. Treatment with the radiolabeled somatostatin analog [177 Lu-DOTA 0, Tyr3]octreotate: Toxicity, efficacy, and survival. J Clin Oncol 2008;26:2124-30.
  • 14 Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, et al. Phase 3 Trial of 177 Lu-dotatate for midgut neuroendocrine tumors. N Engl J Med 2017;376:125-35.
  • 15 FD A resources page. Food and Drug Administration Web site. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-lutetium-lu-177-dotatate-treatment-gep-nets. [Last accessed on 2018 Apr 26].
  • 16 Lassmann M, Eberlein U. Targeted alpha-particle therapy: Imaging, dosimetry, and radiation protection. Ann ICRP 2018;47:187-95.
  • 17 Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, et al. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med 2017;376:125-35.
  • 18 Arnold R, Wilke A, Rinke A, Mayer C, Kann PH, Klose KJ, et al. Plasma chromogranin A as marker for survival in patients with metastatic endocrine gastroenteropancreatic tumors. Clin Gastroenterol Hepatol 2008;6:820-7.
  • 19 Stallons TAR, Saidi A, Tworowska I, Delpassand ES, Torgue JJ. Preclinical Investigation of 212Pb-DOTAMTATE for Peptide Receptor Radionuclide Therapy in a Neuroendocrine Tumor Model. Mol Cancer Ther. 2019;18:1012-21.
  • 20 Morgenstern A, Apostolidis C, Kratochwil C, Sathekge M, Krolicki L, Bruchertseifer F. An overview of targeted alpha therapy with 225Actinium and 213Bismuth. Curr Radiopharm 2018;11:200-8.
  • 21 Kratochwil C, Schmidt K, Afshar-Oromieh A, Bruchertseifer F, Rathke H, Morgenstern A, et al. Targeted alpha therapy of mCRPC: Dosimetry estimate of 213bismuth-PSMA-617. Eur J Nucl Med Mol Imaging 2018;45:31-7.
  • 22 Makis W, McCann K, McEwan AJ, Sawyer MB. Palliation of extensive metastatic bone disease with 223ra-dichloride α-particle therapy in a patient with malignant hereditary paraganglioma-pheochromocytoma syndrome with SDHB mutation. Clin Nucl Med 2016;41:144-7.
  • 23 Kratochwil C, Giesel FL, Bruchertseifer F, Mier W, Apostolidis C, Boll R, et al. 21≥Bi-DOTATOC receptor-targeted alpha-radionuclide therapy induces remission in neuroendocrine tumours refractory to beta radiation: A first-in-human experience. Eur J Nucl Med Mol Imaging 2014;41:2106-19.
  • 24 Ballal S, Yadav MP, Bal C, Sahoo RK, Tripathi M. Broadening horizons with 225Ac-DOTATATE targeted alpha therapy for gastroenteropancreatic neuroendocrine tumour patients stable or refractory to 177Lu-DOTATATE PRRT: First clinical experience on the efficacy and safety. Eur J Nucl Med Mol Imaging 2020;47:934-46.
  • 25 Ocak M, Toklu T, Demirci E, Selçuk N, Kabasakal L. Post-therapy imaging of 225Ac-DOTATATE treatment in a patient with recurrent neuroendocrine tumor. Eur J Nucl Med Mol Imaging 2020;47:2711-2.
  • 26 Zhang J, Kulkarni HR, Baum RP. Peptide receptor radionuclide therapy using 225Ac-DOTATOC achieves partial remission in a patient with progressive neuroendocrine liver metastases after repeated β-emitter peptide receptor radionuclide therapy. Clin Nucl Med 2020;45:241-3.
  • 27 Izabela Tworowska ESD, Julien Torgue, Farah Shanoon, Jason Hurt, Rodolfo Nunez., First-in-human dose escalation of AlphaMedixTM for targeted alpha-emitter therapy of neuroendocrine tumors [abstract], in Proceedings of the Annual Meeting of the American Association for Cancer Research; 2020 Apr 27-28 and Jun 22-24: Philadelphia (PA). AACR; 2020. Abstract nr CT159.