Peptide Receptor Radionuclide Therapy with Lu-177-DOTATATE and Monitoring with Somatostatin Receptor PET/CT in Patients with Advanced Differentiated Thyroid Carcinoma.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Molecular Imaging and Biology Pub Date : 2025-09-29 DOI:10.1007/s11307-025-02053-w

Sophie Carina Kunte, Vera U Wenter, Adrien Holzgreve, Gabriel T Sheikh, Liam Widjaja, Franz Josef Gildehaus, Simon Lindner, Ralf Schirrmacher, Christine Spitzweg, Christoph J Auernhammer, Rudolf A Werner, Mathias J Zacherl

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引用次数: 0

Abstract

Purpose: Peptide receptor radionuclide therapy (PRRT) with Lu-177-DOTATATE is an established treatment option for neuroendocrine tumors (NETs) and has been extended to other somatostatin receptor (SSTR)-expressing tumors. We aimed to determine its efficacy and safety profile in patients with advanced radioiodine-refractory differentiated thyroid carcinoma (DTC).

Methods: Seven radioiodine-refractory DTC patients undergoing at least two cycles of PRRT were included. Patients were subdivided into continuous treatment (defined as sequential application of PRRT; 5/7 (71.4%)) vs. discontinuous treatment (with at least one-year PRRT-free interval; 2/7 (28.6%)). Baseline SSTR PET was analyzed to determine patients' eligibility for PRRT. Response was assessed by tumor control as defined by stable (± 30.0%) or decreasing (≥ 30.0%) total tumor volume (PET-derived TTV), thyroglobulin (Tg) and RECIST 1.1 criteria.

Results: SSTR PET showed discernible high uptake (maximum standardized uptake values, 10.4 ± 8.6) in metastases, in particular in the skeleton. Continuous PRRT showed variable tumor control (stable disease / response; TTV: 3/5 (60.0%); Tg: 2/5 (40.0%); RECIST 1.1: 3/5 (60.0%)). All patients undergoing discontinuous PRRT exhibited concordant stable disease upon first follow-up and renewed tumor control upon reinitiating PRRT (RECIST 1.1; decreasing TTV and Tg levels). No Common Terminology Criteria for Adverse Events (CTCAE) Grade 3-5 events occured in both groups.

Conclusion: In advanced radioiodine-refractory DTC, PRRT may be beneficial even after treatment interruptions, without major side effects. Given the small cohort and retrospective design, further prospective studies are needed to optimize PRRT strategies in DTC, in particular in a rechallenge scenario.

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晚期分化型甲状腺癌患者肽受体核素治疗与生长抑素受体PET/CT监测。

目的：Lu-177-DOTATATE的肽受体放射性核素治疗（PRRT）是神经内分泌肿瘤（NETs）的既定治疗选择，并已扩展到其他表达生长抑素受体（SSTR）的肿瘤。我们的目的是确定其在晚期放射性碘难治性分化甲状腺癌（DTC）患者中的有效性和安全性。方法：7例放射性碘难治性DTC患者接受至少2个周期的PRRT治疗。患者被细分为连续治疗（定义为顺序应用PRRT； 5/7(71.4%)）和间断治疗（至少1年无PRRT间隔；2/7(28.6%)）。分析基线SSTR PET以确定患者是否适合PRRT。通过肿瘤控制（稳定（±30.0%）或减小（≥30.0%）肿瘤总体积（pet衍生TTV）、甲状腺球蛋白（Tg）和RECIST 1.1标准）来评估疗效。结果：SSTR PET显示转移瘤明显的高摄取（最大标准化摄取值，10.4±8.6），特别是在骨骼中。连续PRRT显示可变肿瘤控制(疾病/反应稳定；TTV: 3/5 (60.0%)；Tg: 2/5 (40.0%)；对照1.1:3/5(60.0%))。所有接受间断PRRT的患者在第一次随访时均表现出一致的疾病稳定，并在重新启动PRRT后重新获得肿瘤控制（RECIST 1.1； TTV和Tg水平降低）。不良事件（CTCAE）：两组均发生3-5级不良事件。结论：在晚期放射性碘难治性DTC中，即使在治疗中断后，PRRT也可能是有益的，没有主要的副作用。考虑到小队列和回顾性设计，需要进一步的前瞻性研究来优化DTC的PRRT策略，特别是在再挑战的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Molecular Imaging and Biology 医学-核医学

CiteScore

6.90

自引率

3.20%

发文量

审稿时长

3 months

期刊介绍： Molecular Imaging and Biology (MIB) invites original contributions (research articles, review articles, commentaries, etc.) on the utilization of molecular imaging (i.e., nuclear imaging, optical imaging, autoradiography and pathology, MRI, MPI, ultrasound imaging, radiomics/genomics etc.) to investigate questions related to biology and health. The objective of MIB is to provide a forum to the discovery of molecular mechanisms of disease through the use of imaging techniques. We aim to investigate the biological nature of disease in patients and establish new molecular imaging diagnostic and therapy procedures. Some areas that are covered are: Preclinical and clinical imaging of macromolecular targets (e.g., genes, receptors, enzymes) involved in significant biological processes. The design, characterization, and study of new molecular imaging probes and contrast agents for the functional interrogation of macromolecular targets. Development and evaluation of imaging systems including instrumentation, image reconstruction algorithms, image analysis, and display. Development of molecular assay approaches leading to quantification of the biological information obtained in molecular imaging. Study of in vivo animal models of disease for the development of new molecular diagnostics and therapeutics. Extension of in vitro and in vivo discoveries using disease models, into well designed clinical research investigations. Clinical molecular imaging involving clinical investigations, clinical trials and medical management or cost-effectiveness studies.