Alpha Before Beta: Exceptional Response to First-Line 225Ac-DOTATATE in a Patient of Metastatic Neuroendocrine Tumor With Extensive Skeletal Involvement. (February 2022)

• Record Type: Journal Article
• Authors: Satapathy, Swayamjeet; Sood, Ashwani; Das, Chandan Krushna; Kavanal, Anwin Joseph; Mittal, Bhagwant Rai
• Is Part Of: Clinical nuclear medicine. Volume 47:Number 2(2022)
• Publication Date: 2022-02
• Subjects: peptide receptor radionuclide therapy -- PRRT -- 225Ac-DOTATATE -- α therapy -- neuroendocrine tumor; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000003823
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Abstract: The utility of β-emitter 177 Lu-DOTATATE in patients of neuroendocrine tumors (NETs) with widespread skeletal metastases is limited by its relatively modest response rates and a significant concern for hematotoxicity. In such situations, targeted α therapy with 225 Ac-DOTATATE can be potentially beneficial. In this report, a 46-year-old man with rectal NET and extensive skeletal metastases was treated upfront with 6 cycles of 225 Ac-DOTATATE at 8 weeks' intervals. The patient showed excellent symptomatic, biochemical, and radiological response with no grade 3/4 adverse events. The first-line use of 225 Ac-DOTATATE, therefore, presents a novel strategy for metastatic NETs with high skeletal disease burden.