Journal article
90Y-Edotreotide for Metastatic Carcinoid Refractory to Octreotide
Journal of clinical oncology, Vol.28(10), pp.1652-1659
04/01/2010
DOI: 10.1200/JCO.2009.22.8585
PMCID: PMC4872330
PMID: 20194865
Abstract
Purpose Metastatic carcinoid is an incurable malignancy whose symptoms, such as diarrhea and flushing, can be debilitating and occasionally life-threatening. Although symptom relief is available with octreotide, the disease eventually becomes refractory to octreotide, leaving no proven treatment options. The goal of this study was to evaluate the clinical effect of using 90Y-edotreotide to treat symptomatic patients with carcinoid tumors. Patients and Methods Patients enrolled had metastatic carcinoid, at least one sign/symptom refractory to octreotide, and at least one measurable lesion. Study treatment consisted of three cycles of 4.4 GBq (120 mCi) 90Y-edotreotide each, once every 6 weeks. Results Ninety patients were enrolled in the study. Using Southwest Oncology Group tumor response criteria, 67 (74.%) of 90 patients (95% CI, 65.4% to 83.4%) were objectively stable or responded. A statistically significant linear trend toward improvement was demonstrated across all 12 symptoms assessed. Median progression-free survival was significantly greater (P = .03) for the 38 patients who had durable diarrhea improvement than the 18 patients who did not (18.2 v 7.9 months, respectively). Adverse events (AEs) were reported in 96.7% (87 of 90) of patients. These AEs consisted primarily of reversible GI events (76 of 90), which could be caused in part by concomitant administration of amino acid solution given to reduce radiation exposure to the kidneys. There was one case each of grade 3 oliguria and grade 4 renal failure, each lasting 6 days. Conclusion 90Y-edotreotide treatment improved symptoms associated with malignant carcinoid among subjects with no treatment alternatives. Treatment was well-tolerated and had an acceptable expected AE profile.
Details
- Title: Subtitle
- 90Y-Edotreotide for Metastatic Carcinoid Refractory to Octreotide
- Creators
- David L Bushnell - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalThomas M O'Dorisio - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalM. Sue O'Dorisio - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalYusuf Menda - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalRodney J Hicks - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalEric Van Cutsem - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalJean-Louis Baulieu - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalFrancoise Borson-Chazot - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalLowell Anthony - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalAl B Benson - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalKjell Oberg - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalAshley B Grossman - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalMary Connolly - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalHakim Bouterfa - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalYong Li - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalKatherine A Kacena - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalNorman LaFrance - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University HospitalStanislas A Pauwels - From the Department of Radiology, Division of Nuclear Medicine, the Department of Internal Medicine, Division of Endocrinology, and Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Iowa, Roy J. and Lucille A. Carver College of Medicine; Iowa City Veterans Administration Medical Center, Diagnostic Imaging and Radioisotope Therapy Service, Iowa City, IA; Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia; Digestive Oncology Unit, University Hospital
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.28(10), pp.1652-1659
- DOI
- 10.1200/JCO.2009.22.8585
- PMID
- 20194865
- PMCID
- PMC4872330
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 04/01/2010
- Academic Unit
- Radiology; Stead Family Department of Pediatrics; Radiation Oncology; Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9984046818602771
Metrics
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