Safety and Efficacy of Peptide-Receptor Radionuclide Therapy in Elderly Neuroendocrine Tumor Patients

Cancers

Marco Cattaneo¹  Peter Igaz²  M. Sue O’Dorisio³  Thomas O’Dorisio³  Lawrence O. Dierickx⁴  Claire Bournaud⁵  Deborah Theiler⁶  Guillaume P. Nicolas⁶  Damian Wild⁶  Simona Grozinsky-Glasberg⁷  Emanuel Christ⁸ 

[1] Department of Clinical Research, University of Basel, 4031 Basel, Switzerland;Department of Endocrinology, Department of Internal Medicine and Oncology, ENETS CoE, Semmelweis University, 1085 Budapest, Hungary;Department of Endorinology, Stead Family Children’s Hospital, University of Iowa, Iowa City, IA 52242, USA;Department of Nuclear Medicine, ENETS CoE, Institut Universitaire du Cancer Toulouse-Oncopole, 31100 Toulouse, France;Department of Nuclear Medicine, Hospices Civils de Lyon, 69310 Lyon, France;Division of Nuclear Medicine, University Hospital of Basel, 4031 Basel, Switzerland;Neuroendocrine Tumor Unit, Department of Endocrinology and Metabolism, ENETS CoE, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel;Neuroendocrine and Endocrine Tumour Centre, ENETS CoE, University Hospital of Basel, 4031 Basel, Switzerland;

关键词: neuroendocrine tumour;    peptide receptor radionuclide therapy;    elderly patients;    ¹⁷⁷Lu-DOTATOC;    ⁹⁰Y-DOTATOC;   

DOI  :  10.3390/cancers13246290

来源: DOAJ

【 摘 要 】

Peptide receptor radionuclide therapy (PRRT) is a well-established treatment in somatostatin receptor-expressing neuroendocrine tumours (NETs). The safety and efficacy of PRRT in >79 years old patients (EP) have not been systematically investigated. All patients with inoperable/metastatic/progressive G1/G2 NET, >79 years (EP), treated with PRRT at the University Hospital of Basel between 2006 and 2018, were enrolled in this retrospective matched cohort study. Each patient was manually matched with ≥1 younger patient (YP = 60–70 years). The primary endpoint was toxicity. Toxicity (subacute, long-term) was graded according to the criteria for adverse events (CTCAE) v5.0. All toxicity grades ≥ 3, or whose delta (Δ) to baseline were ≥2, were considered significant. The odds ratio (OR) for developing toxicity was tested for non-inferiority of EP vs. YP. Clinical response to PRRT and overall survival (OS) were assessed as secondary outcome measures. Forty-eight EP and 68 YP were enrolled. Both cohorts were balanced regarding median time since diagnosis, tumour location, grading, treatment scheme, and baseline biochemical parameters, except for eGFR (EP: 61 ± 16 vs. YP: 78 ± 19; mL/min/1.73 m²). Twenty-two grade ≥ 3 or Δ ≥ 2 subacute hematotoxicities occurred in 10 EP (10.3% of cycles) and 37 in 19 YP (11.6% of cycles; p = NS). Long-term grade ≥ 3 renal toxicity occurred in 7 EP and 2 YP (p = NS). The median OS was 3.4 years (EP) vs. 6.0 years (YP), HR: 1.50 [0.75, 2.98], p = NS. PRRT is a valid therapeutic option in elderly NET patients with similar toxicity and non-inferior survival compared to matched younger patients.

【 授权许可】

Unknown