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Een behandeling met 177LU-DOTATATE, een inwendige bestraling van het beenmerg / ruggegraat met name, bij patiënten met neuro-endocriene tumoren, ook wel NET tumorenofcarcinoidgenoemd, geeft uitstekende resultaten op een remissie en overall overleving in alle stadia. Vooral patiënten met NET tumoren gerelateerd aan de alvleesklier reageerden heel erg goed op deze behandeling. Nog beter dan NET tumoren gerelateerd aan spijsverteringskanker.
Hier de resultaten uit een overzichtstudie van totaal 14 studies met totaal 1844 deelnemende patiënten vertaald in het Nederlands:
Resultaten:
In totaal werden 14 studies met 1844 patiënten geïncludeerd.
Het gevonden ziektecontrolepercentage (DCR) was 87,6% (95% betrouwbaarheidsinterval (BI), 82,5%-92%), en het objectieve responspercentage (ORR) was 32,2% (95% BI, 25,4%-39,3%).
De mediane progressievrije overleving (PFS) was 30,87 maanden (95% BI, 22,71-39,04), en de mediane algehele overleving (OS) was 51,85 maanden (95% BI, 39,99-63,71).
Subgroepanalyse toonde een significant hogere ziektecontrolepercentage (DCR) bij NET's van graad 1-2: 97,7% (95% CI, 91,4%-100%) vergeleken met NET's van graad 3: 90,8% (95% CI, 85,1%-94,4%).
Ook de objectieve responspercentage (ORR) was hoger bij tumoren van graad 1-2: 45,4% (95% CI, 35,3%-55,6%) vergeleken met 27,1% (95% CI, 21,2%-33,4%).
De ziektevrije overleving (PFS) was langer bij pancreas-NET's: 93,9 maanden (95% CI, 39,45-148,35) dan bij gastro-intestinale NET's: 66,32 maanden (95% CI, 41,78-90,87).
De totale incidentie van bijwerkingen was 4,1%, waarvan 4,3% toxiciteit van graad ≥3 betrof.
177Lu-PRRT vertoont een hoge werkzaamheid en een gunstig veiligheidsprofiel bij de behandeling van NET's.
Conclusie: Deze meta-analyse toont aan dat 177LU-DOTATATE een gunstig werkzaamheids- en veiligheidsprofiel heeft bij patiënten met neuro-endocriene tumoren (NET's). De bevindingen suggereren verder dat patiënten met goed gedifferentieerde (G1 of G2) NET's mogelijk in het bijzonder baat hebben bij behandeling met 177LU-DOTATATE. Desalniettemin zijn aanvullende klinische studies van hoge kwaliteit, met name prospectieve gerandomiseerde gecontroleerde studies, nodig om deze conclusies te bevestigen en de integratie van 177LU-DOTATATE-therapie in de klinische praktijk te bevorderen.
Het volledige studierapport is gratis te lezen of te downloaden. Klik op de titel van het abstract van de studie:
1. Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
2. Heilongjiang Province Key Laboratory of Research on Molecular Targeted Anti-Tumor Drugs, Harbin, China
Abstract
Objective:
This systematic review and meta-analysis evaluated the efficacy and safety of 177Lu-labelled peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NETs).
Methods:
This systematic review and meta-analysis conducted a search of the PubMed/MEDLINE, Embase, and Web of Science databases. Included studies assessed treatment outcomes using Response Evaluation Criteria in Solid Tumors (RECIST) or World Health Organization (WHO) criteria. A random-effects model was used to calculate pooled proportions.
Results:
A total of 14 studies with 1844 patients were included. The pooled disease control rate (DCR) was 87.6% (95% Confidence Interval (CI), 82.5%-92%), and the objective response rate (ORR) was 32.2% (95% CI, 25.4%-39.3%). Median progression-free survival (PFS) was 30.87 months (95% CI, 22.71–39.04), and median overall survival (OS) was 51.85 months (95% CI, 39.99–63.71). Subgroup analysis revealed a significantly higher DCR in grade 1–2 NETs 97.7% (95% CI, 91.4%-100%) compared to grade 3 NETs 90.8% (95% CI, 85.1%-94.4%), and a higher ORR in grade 1–2 tumors 45.4% (95% CI, 35.3%-55.6%) compared to grade 3 tumors 27.1% (95% CI, 21.2%-33.4%). PFS was longer in pancreatic NETs 93.9 months (95% CI, 39.45–148.35) than in gastrointestinal NETs 66.32 months (95% CI, 41.78–90.87). The overall incidence of adverse events was 4.1%, with grade ≥3 toxicities in 4.3%. 177Lu-PRRT demonstrates high efficacy and a favorable safety profile in treating NETs.
Conclusion:
This meta-analysis demonstrates that 177Lu-DOTATATE has a favorable efficacy and safety profile in patients with NETs. The findings further suggest that patients with well-differentiated (G1 or G2) NETs may derive particular benefit from 177Lu-DOTATATE therapy. Nevertheless, additional high-quality clinical trials, especially prospective randomized controlled trials, are warranted to confirm these conclusions and to facilitate the integration of 177Lu-DOTATATE therapy into clinical practice.Systematic Review Registration:
The original contributions presented in the study are included in the article/Supplementary Material. Further inquiries can be directed to the corresponding authors.
The author(s) declared that financial support was received for this work and/or its publication. This work was supported by the National Natural Science Foundation of China (grant no. 62372141,82303742), Key Research and Development Program of Heilongjiang Province (2023ZX06C09), China Postdoctoral Science Foundation (grant no.,2024T170205), Haiyan Foundation of Harbin Medical University Cancer Hospital (JJZD2024 - 16).
Conflict of interest
The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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The author(s) declared that generative AI was not used in the creation of this manuscript.
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