Journal article
The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours
European journal of nuclear medicine and molecular imaging, Vol.40(5), pp.800-816
2013
DOI: 10.1007/s00259-012-2330-6
PMCID: PMC3622744
PMID: 23389427
Abstract
Peptide receptor radionuclide therapy (PRRNT) is a molecularly targeted radiation therapy involving the systemic administration of a radiolabelled peptide designed to target with high affinity and specificity receptors overexpressed on tumours. PRRNT employing the radiotagged somatostatin receptor agonists 90Y-DOTATOC ([90Y-DOTA0,Tyr3]-octreotide) or 177Lu-DOTATATE ([177Lu-DOTA0,Tyr3,Thr8]-octreotide or [177Lu-DOTA0,Tyr3]-octreotate) have been successfully used for the past 15 years to target metastatic or inoperable neuroendocrine tumours expressing the somatostatin receptor subtype 2. Accumulated evidence from clinical experience indicates that these tumours can be subjected to a high absorbed dose which leads to partial or complete objective responses in up to 30 % of treated patients. Survival analyses indicate that patients presenting with high tumour receptor expression at study entry and receiving 177Lu-DOTATATE or 90Y-DOTATOC treatment show significantly higher objective responses, leading to longer survival and improved quality of life. Side effects of PRRNT are typically seen in the kidneys and bone marrow. These, however, are usually mild provided adequate protective measures are undertaken. Despite the large body of evidence regarding efficacy and clinical safety, PRRNT is still considered an investigational treatment and its implementation must comply with national legislation, and ethical guidelines concerning human therapeutic investigations. This guidance was formulated based on recent literature and leading experts’ opinions. It covers the rationale, indications and contraindications for PRRNT, assessment of treatment response and patient follow-up. This document is aimed at guiding nuclear medicine specialists in selecting likely candidates to receive PRRNT and to deliver the treatment in a safe and effective manner. This document is largely based on the book published through a joint international effort under the auspices of the Nuclear Medicine Section of the International Atomic Energy Agency.
Details
- Title: Subtitle
- The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours
- Creators
- John J Zaknun - Nuclear Medicine Section, Division of Human Health, International Atomic Energy Agency, IAEA, Vienna, AustriaL Bodei - Division of Nuclear Medicine, European Institute of Oncology, Milan, ItalyJ Mueller-Brand - Klinik und Institut für Nuklearmedizin, Universitätsspital Basel, Basel, SwitzerlandM. E Pavel - Campus Virchow Klinikum, Klinik für Gastroenterologie, Hepatologie, Endokrinologie, Diabetes und Stoffwechsel-erkrankungen, Charité Universitaetsmedizin Berlin, Berlin, GermanyR. P Baum - Zentralklinik Bad Berka, Department of Internal Medicine, Gastroenterology and Endocrinology, ENETS Center of Excellence, Bad Berka, GermanyD Hörsch - Zentralklinik Bad Berka, Department of Internal Medicine, Gastroenterology and Endocrinology, ENETS Center of Excellence, Bad Berka, GermanyM. S O’Dorisio - RJ and LA Carver College of Medicine, Department of Pediatrics, University of Iowa, Iowa City, IA USAT M OʼDorisio - RJ and LA Carver College of Medicine, Department of Internal Medicine, University of Iowa, Iowa City, IA USAJ. R Howe - RJ and LA Carver College of Medicine, Department of Surgical Oncology, University of Iowa, Iowa City, IA USAM Cremonesi - Service of Health Physics, European Institute of Oncology, Milan, ItalyD. J Kwekkeboom - Department of Nuclear Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Resource Type
- Journal article
- Publication Details
- European journal of nuclear medicine and molecular imaging, Vol.40(5), pp.800-816
- DOI
- 10.1007/s00259-012-2330-6
- PMID
- 23389427
- PMCID
- PMC3622744
- NLM abbreviation
- Eur J Nucl Med Mol Imaging
- ISSN
- 1619-7070
- eISSN
- 1619-7089
- Publisher
- Springer Berlin Heidelberg; Berlin/Heidelberg
- Language
- English
- Date published
- 2013
- Academic Unit
- Stead Family Department of Pediatrics; Surgery; Endocrinology and Metabolism; Internal Medicine
- Record Identifier
- 9984051582802771
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