Pregnancy and delivery after PRRT without sequelae

Ziel/Aim:

Peptide receptor radionuclide therapy (PRRT) with radiolabelled somatostatin analogues has been proven very useful in the management of advanced, well differentiated neuroendocrine neoplasia (NEN). However, little is known about pregnancy outcomes in patients who have received therapeutic activities of radiolabelled peptides, keeping in mind probable negative radiation effects. We present here the pregnancy outcome in NEN patients, who have received several cycles of PRRT.

Methodik/Methods:

Clinical features, treatment parameters, pregnancy and birth outcomes in four young NEN patients (3 females and 1 male, age 28 – 39 y, mean age 33.0 ± 4.7 y), who successfully gave birth to (or fathered) a child after having received PRRT with Lu-177 or Y-90 labelled DOTATATE/DOTATOC/DOTA-JR11.

Ergebnisse/Results:

metastases, 1 pancreatic NEN with liver, lymph node and cardiac metastases, 1 jejunum NEN with liver metastases, and 1 female patient having NEN origin in the ovary with extensive peritoneal, lymph node and liver metastases. 2 patients were treated with Lu-177 DOTATATE/-TOC, whereas the other 2 patients received DUO-PRRT. The median administered activity was 20 GBq (range 13 – 27 GBq) in 3 – 4 cycles. Treatment was tolerated extremely well by all patients without significant adverse effects. After 3 – 4 cycles of PRRT, CR was achieved in 2/4 and PR in 2/4 by both, EORTC and RECIST criteria. Conception in one female patient was by in-vitro fertilization, whereas the mode of conception was natural in the other 3 cases. All the new-borns were healthy and exhibited no malformations. All the children had normal development in the follow-up period until September 2018. One male patient has fathered two children. The intervals from first PRRT to birth were 20, 37, 52, 83 and 95 months, whereas that from the last PRRT cycle to birth were 12, 27, 42, 67 and 84 months, respectively. All patients were alive with a follow-up period of 61 – 120 months after first PRRT.

Schlussfolgerungen/Conclusions:

Our results indicate that pregnancy and birth without sequelae are possible in patients with NEN who have been treated with PRRT, and offer a definitive prospect for patients of reproductive age group who plan conception despite having received or due to undergo PRRT.

 

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