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Nuklearmedizin 2017; 56(01): 1-8
DOI: 10.3413/Nukmed-0860-16-11
Original article
Schattauer GmbH

Twins in spirit part IV – [177Lu] high affinity DOTATATE

A promising new tracer for peptide receptor radiotherapy?Zwillinge im Geiste, Teil IV – [177Lu]-high-affinity- DOTATATEEin vielversprechender neuer Tracer für die Peptid-Rezeptor-Radiotherapie?
Claudia Brogsitter
1   Department of Nuclear Medicine, Technische Universität Dresden, Germany
,
Holger Hartmann
1   Department of Nuclear Medicine, Technische Universität Dresden, Germany
,
Gerd Wunderlich
1   Department of Nuclear Medicine, Technische Universität Dresden, Germany
,
Margret Schottelius
2   Pharmaceutical Radiochemistry and Department of Nuclear Medicine, Technische Universität München, München, Germany
,
Hans-Jürgen Wester
2   Pharmaceutical Radiochemistry and Department of Nuclear Medicine, Technische Universität München, München, Germany
,
Jörg Kotzerke
1   Department of Nuclear Medicine, Technische Universität Dresden, Germany
› Author Affiliations
Further Information

Publication History

received: 10 November 2016

accepted in revised form: 26 January 2017

Publication Date:
02 January 2018 (online)

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Summary

Aim: Besides the use of somatostatin analogues, small molecules like sunitinib and everolimus as well as conventional chemotherapy, peptide receptor radiotherapy (PRRT) using radiolabelled somatostatin analogues has gained an important role in the treatment of inoperable, metastasized neuroendocrine tumours (NET). There are various radiotracers in use. Based on our experience with the PET tracer [68Ga]DOTA-3-iodo- Tyr3-octreotate ([68Ga]HA-DOTATATE), a DOTATATE derivative with an increased binding affinity to hsst5, the current retrospective analysis is exploring the therapeutic potential of [177Lu]HA-DOTATATE. Methods: Eighteen patients with metastatic NET (G1/G2) were treated using [177Lu]DOTATATE and/or [177Lu]HA-DOTATATE, and dosimetric results of both tracers were compared. Results: Using [177Lu]HA-DOTATATE, a mean tumour dose of 5.34 Gy/GBq (median 2.53 Gy/ GBq; range 0.89-33.3 Gy/GBq) was achieved, while [177Lu]DOTATATE delivered a tumour dose of 5.53 Gy/GBq (median 2.70 Gy/GBq; range 0.44-15.3 Gy/GBq). Organ doses for [177Lu]HA-DOTATATE vs. [177Lu]DOTATATE were as follows: kidney 2.31 ± 0.85 vs. 2.03 ± 0.96 Gy/GBq, liver 1.6 ± 0.79 vs. 1.67 ± 1.73 Gy/GBq, spleen 3.89 ± 4.04 vs. 4.50 ± 3.69 Gy/GBq and whole body 0.16 ± 0.10 Gy/GBq vs. 0.15 ± 0.08 Gy/ GBq. Tumour-to-kidney dose ratio was slightly higher for [177Lu]DOTATATE (2.4 ± 5.6) compared to [177Lu]HA-DOTATATE (1.5 ± 3.6). Conclusion: Both tracers showed marked inter-patient variation in their dosimetry, and no significant differences in dosimetry of [177Lu]HA- DOTATATE and [177Lu]DOTATATE were observed when taking all patients into account. Thus, [177Lu]HA-DOTATATE appears viable for PRRT, although it was marginally inferior regarding kidney dose and tumour-to-kidney dose ratio compared to the established [177Lu]DOTATATE.

Zusammenfassung

Ziel: Basierend auf unseren Erfahrungen mit dem PET-Tracer[68Ga]DOTA-3-iodo-Tyr3 octreotate ([68Ga]HA-DOTATATE) wurde in der vorliegenden retrospektiven Analyse das therapeutische Potential von Lu-177 markiertem HA-DOTATATE untersucht. Methode: 18 Patienten mit metastasiertem NET (G1/G2) wurden mit [177Lu]DOTATATE und/oder [177Lu]HA-DOTATATE therapiert und in einer retrospektiven Auswertung die dosimetri- schen Ergebnisse beider Radiopharmaka verglichen. Ergebnisse: Mit [177Lu]HA-DOTATATE wurde eine mittlere Tumordosis von 5.34 Gy/ GBq (Median 2.53 Gy/GBq; Spannbreite 0.89-33.3 Gy/GBq) erreicht, während mit [177Lu]DOTATATE eine mittlere Tumordosis von 5.53 Gy/GBq (Median 2.70 Gy/GBq; Spannbreite 0.44-15.3 Gy/GBq) erzielt wurde. Die folgenden Organdosen wurden für [177Lu]HA-DOTATATE ermittelt: Niere 2.31 ± 0.85 Gy/GBq, Leber 1.06 ± 0.79 Gy/ GBq, Milz 3.89 ± 4.04 Gy/GBq und Ganzkörper 0.16 ± 0.10 Gy/GBq. Für [177Lu]DOTATATE wurden folgende Dosen bestimmt: Niere 2.03 ± 0.96 Gy/GBq, Leber 1.67 ± 1.73 Gy/ GBq, Milz 4.50 ± 3.69 Gy/GBq und Ganzkörper 0.15 ± 0.08 Gy/GBq. Das Tumor-zu- Nierenverhältnis war für [177Lu]DOTATATE (2.4 ± 5.6) etwas besser verglichen mit [177Lu]HA-DOTATATE (1.5 ± 3.6). Schlussfolgerung: Die dosimetrischen Ergebnisse beider Radiotracer weisen eine hohe interindividuelle Schwankungsbreite auf. Signifikante Unterschiede hinsichtlich Organ- und Tumordosen konnten nicht festgestellt werden. Die mittlere Tumordosis und das Tumor- zu-Nierenverhältnis waren für [177Lu]HA- DOTATATE tendenziell schlechter als für [177Lu]DOTATATE.

Keywords

PRRT - dosimetry - HA-DOTATATE - DOTATATE

Schlüsselwörter

PRRT - Dosimetrie - HA-DOTATATE - DOTATATE
 

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