Frontiers in Endocrinology (Apr 2021)

Case Report: Re-Treatment With Lu-DOTATATE in Neuroendocrine Tumors

  • Elena María Vida Navas,
  • Alberto Martínez Lorca,
  • Aintzane Sancho Gutiérrez,
  • Lucia Sanz Gómez,
  • Teresa Navarro Martínez,
  • Enrique Grande Pulido,
  • Alfredo Carrato Mena,
  • Pablo Gajate Borau

DOI
https://doi.org/10.3389/fendo.2021.676973
Journal volume & issue
Vol. 12

Abstract

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Peptide receptor radionuclide therapy (PRRT) is an established treatment in advanced neuroendocrine tumors (NETs), which overexpressed somatostatin receptors. However, after progression there are a limited number of available treatments. We want to share a case report about a patient with a NET re-treated with 177Lu-DOTATATE and a literature review about salvage treatment with PRRT. We present a 26-year-old man who started with pelvic pain and after a biopsy of a retro-rectal mass observed in a magnetic resonance was diagnosed with an advanced neuroendocrine tumour. After progression to lanreotide, everolimus and sunitinib, treatment with 177Lu-DOTATATE was initiated, achieving an excellent response with a progression free survival (PFS) of 38 months. At the time of progression, re-treatment with 177Lu-DOTATATE was decided, showing a new partial response, which is currently stable after 15 months. The patient had not presented significant treatment-related toxicity. Although there are no randomized phase III trials or a consensus about the number or dose of cycles, there is evidence about the efficacy and low toxicity of salvage treatment with 177Lu-DOTATATE in NETs. Median progression-free survival ranges from 6 to 22 months. Toxicity is mostly hematologic (anemia and neutropenia), 4-7% grade 3/4.

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