Dataset Information

Survival predictors of ¹⁷⁷Lu-Dotatate peptide receptor radionuclide therapy (PRRT) in patients with progressive well-differentiated neuroendocrine tumors (NETS).

ABSTRACT:

Purpose

¹⁷⁷Lu-Dotatate is an emerging treatment modality for patients with unresectable or metastatic well-differentiated NETs. This study examines survival predictors in patients who received ¹⁷⁷Lu-Dotatate.

Methods

A retrospective single-center review was conducted, examining 47 individuals with progressive well-differentiated NETs treated with ¹⁷⁷Lu-Dotatate (four induction cycles of 5.5 GBq at 10-week intervals followed by eight maintenance cycles of 3.7 GBq at 6-month intervals).

Results

Median follow-up was 63.1 months with a median progression-free survival (PFS) of 34.1 months. However, median overall survival (OS) was not reached at the time of analysis. The presence of ≥ 5 bone metastases (hazard ratio HR 4.33; p = 0.015), non-gastroenteropancreatic (non-GEP) NETs (HR 3.22; p = 0.025) and development of interim ascites (HR 3.15; p = 0.047) independently predicted a worse OS. Patients with chromogranin A of ≥ 4 × upper limit of normal (ULN) had shorter OS (p < 0.001) and PFS (p = 0.004). Similarly, those with pre-existing ascites demonstrated a worse OS (p = 0.009) and PFS (p = 0.026). Liver metastases involving greater than 50% liver volume and the existence of unusual metastatic locations had a negative impact on OS (p = 0.033) and PFS (p = 0.026), respectively.

Conclusion

High burden of skeletal and hepatic metastases, non-GEP-NETs, chromogranin A of ≥ 4 × ULN, unusual metastatic sites, pre-existing and interim ascites are predictors of poor outcomes in patients treated with ¹⁷⁷Lu-Dotatate. These common indicators can be used for the risk stratification and identification of patients most likely to benefit from PRRT.

Trial registration

ClinicalTrials.gov identifier: NCT02236910, Retrospectively registered on September, 2014.

SUBMITTER: Swiha MM

PROVIDER: S-EPMC8752529 | biostudies-literature |

REPOSITORIES: biostudies-literature

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