Lutathera Therapy in Olfactory Neuroblastoma

Background: Olfactory neuroblastoma (ONB) is a rare neuroectodermal tumor of the nasal cavity and paranasal sinuses. Treatment options for multiply recurrent disease or distant metastases are limited. Most of these tumors express somatostatin receptors (SSTR), providing a potential target for peptide-radionuclide receptor therapy (PRRT). Lutathera is a form of PRRT that specifically targets the SSTR receptor. Numerous publications have shown the utility of Lutathera in gastrointestinal neuroendocrine tumors, but its benefit in treating ONB remains unclear.

Methods: A multi-institutional retrospective review of recurrent and metastatic ONB treated with Lutathera was performed. Patients with available DOTATATE imaging were included. Demographics, tumor location and grade, metastasis/recurrence information, previous therapy, imaging modalities, complications, and pathology information (e.g., SSTR expression) were extracted from patient charts. A full course of Lutathera was defined as 4 treatments. Patients completed complete blood count (CBC) and complete metabolic panel (CMP) during therapy. Response to therapy was monitored with DOTATATE imaging.

Results: Twenty-three patients received Lutathera therapy and were included. All patients had recurrent metastatic ONB and had received prior therapy. Treatment sites included intracranial and extracranial disease. Treatment was generally well tolerated. Although myelosuppression of bone marrow and other toxicities were observed, therapy was discontinued in only two patients. With ongoing follow-up of up to 4 years, significant and sustained responses to treatment have been observed.

Conclusion: Lutathera was generally well-tolerated in this cohort, with few patients requiring cessation of therapy. While our sample size is limited, it represents the largest cohort of ONB treated with Lutathera. Initial responses to Lutathera are promising and support larger clinical trials for recurrent or metastatic ONB.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
07 February 2025