nach oben

European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.10.2008 | Original Article

Selective hepatic arterial infusion of In-111-DTPA-Phe¹-octreotide in neuroendocrine liver metastases

verfasst von: Georgios S. Limouris, Achilles Chatziioannou, Dimitrios Kontogeorgakos, Dimitrios Mourikis, Maria Lyra, Panagiotis Dimitriou, Anastasia Stavraka, Athanassios Gouliamos, Lambros Vlahos

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 10/2008

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study is to evaluate the effectiveness of ¹¹¹In-DTPA-Phe¹-octreotide infusions after selective catheterization of the hepatic artery in inoperable metastasised liver, sst₂ receptor-positive neuroendocrine tumours due to the effect of ¹¹¹In Auger electron emission, minimising in parallel the toxicity of non-target tissue.

Methods

The average dose per session administered monthly to each patient (17 cases in total) was 6.3 ± 2.3 GBq. Repetitions did not exceed 12-fold, except in one case (15 sessions). Response assessment was classified according to the Response Evaluating Criteria in Solid Tumours. CT/MRI scans were performed as baseline before, during and after the end of treatment, and monthly ultrasound images for follow-up measurements. Toxicity (World Health Organization criteria) was measured using blood and urine tests of renal, hepatic and bone marrow function.

Results

Complete response was achieved in one (5.9%) patient and partial in eight (47.0%), and disease stabilization in 3 (17.7%) patients; five (29.4%) did not respond. A 32-month median survival time was estimated in 12 (70.5%). Nine of these 12 surviving had a mean target diameter shrinkage from 144 ± 81 to 60 ± 59 mm. Grade 1 erythro-, leuko- and thrombo-cytopenia occurred in three (17.6%) cases.

Conclusion

In unresectable metastatic liver lesions positive for somatostatin receptors repeated, transhepatic high doses of ¹¹¹In-DTPA-Phe¹-octreotide show an effective therapeutic outcome. Given the locoregional modality character of the administration technique plus the extremely short range of ¹¹¹In Auger and internal conversion electrons emission, no nephro-, liver- or myelo-toxicity has so far been observed.

Patel YC. Somatostatin and its receptor family. Front Neuroendocrinol. 1999;20:157–98.PubMedCrossRef

Janson ET, Westlin J-E, Öhrvall U, Öberg K, Lukinius A. Nuclear localization of ¹¹¹In after intravenous injections of [¹¹¹In-DTPA-d-Phe¹]-octreotide in patients with neuroendocrine tumors. J Nucl Med. 2000;41:1514–8.PubMed

Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with [111In-DTPA-d-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med. 1993;20:716–31.PubMedCrossRef

De Jong M, Bernard BF, De Bruin E, Van Gameren A, Bakker WH, Visser TJ, et al. Internalization of radiolabelled [DTPA°]octreotide and [DOTA°, Tyr³]octreotide: peptides for somatostatin receptor-targeted scintigraphy and radionuclide therapy. Nucl Med Commun. 1998;19:283–8.PubMedCrossRef

Anderson P, Forssel-Aronsson E, Johanson V, Wängberg B, Nilsson O, Fjälling M, et al. Internalization of indium-111 into human neuroendocrine tumor cell after incubation with indium-11-DTPA-d-Phe¹-octreotide. J Nucl Med. 1996;37:2002–6.

Bass LA, Lanahan MV, Duncan JR, Erion JL, Srinivasan A, Schmidt MA, et al. Identification of the soluble in vivo metabolites of indium-111-diethylenetriaminepentaacetic acid-d-Phe1-octreotide. Bioconjug Chem. 1998;9:192–200.PubMedCrossRef

Krenning EP, Kooij PPM, Bakker WH, Breeman WA, Postema PT, Kwekkeboom DJ, et al. Radiotherapy with a radiolabeled somatostatin analogue, [¹¹¹In-DTPA-D.Phe¹]-octreotide; a case history. Ann NY Acad Sci 1994;733:496–506.PubMedCrossRef

Kaltsas GA, Stefanidou Z, Papadogias D, Grossmann A. Treatment of advanced neuroendocrine tumours with radiolabelled somatostatin analogue octreotide. Hormones. 2002;1(3):149–56.PubMed

Adelstein SJ. The Auger process: a therapeutic promise? AJR. 1993;160:707–13.PubMed

10.

Breeman WA, De Jong M, Kwekkeboom DK, Valkema R, Bakker WH, Kooij PPM, et al. Somatostatin receptor-mediated imaging and therapy: basic science, current knowledge, limitations and future perspectives. Eur J Nucl Med. 2001;28:1421–9.PubMedCrossRef

11.

McLean JR, Wilkinson D. The radiation dose to cells in vitro from intracellular indium-111. Biochem Cell Biol. 1989;67:661–5.PubMedCrossRef

12.

Mariani G, Bodei L, Adelstein SJ, Kassis AI, et al. Emerging roles for radiometabolic therapy of tumours based on auger electron emission. J Nucl Med. 2000;41:1519–21.PubMed

13.

Kassis AI, Adelstein SJ. Radiobiologic principles in radionuclide. therapy. J Nucl Med. 2005;46:4S–12S.PubMed

14.

Wiseman GA, Kvols LK. The radiolabelled MIBG and Somatostatin analogues. Semin Nucl Med 1995;XXV(3):272–8.CrossRef

15.

De Jong M, Bakker WH, Krenning EP, Breeman WAP, Van der Pluijm ME, Bernard BF, et al. Yttrium-90 and indium-111 labelling, receptor binding and biodistribution of [DOTA, D-Phe¹, Tyr³]-octreotide; a promising somatostatin analogue for radionuclide therapy. Eur J Nucl Med. 1997;24:368–71.PubMedCrossRef

16.

Limouris GS, Lyra M, Skarlos D, Hatziioannou A, Gouliamos A, Moulopoulou A, et al. Auger and conversion electron therapy with In-111 pentetreotide in hepatocellular carcinoma. In: Bergmann H, Koehn H, Sinzinger H, editors. Radioactive isotopes in clinical medicine and research. Boston: Birkhäuser; 1999. p. 551–4.

17.

Valkema R, De Jong M, Bakker WH, Breeman WAP, Kooij PPM, Lugtenburg PJ, et al. Phase I study of peptide receptor radionuclide therapy with [¹¹¹In-DTPA°]octreotide: the Rotterdam experience. Semin Nucl Med. 2002;32(2):110–22.PubMedCrossRef

18.

Kwekkeboom DJ, Bakker WH, Kam BL, Teunissen JJM, Kooij PPM, De Herder WW, et al. Treatment of patients with gastro-entero-pancreatic (GEP) tumours with the novel radiolabelled somatostatin analogue [177Lu-DOTA°, Tyr³]octreotate. Eur J Nucl Med. 2003;30:417–22.

19.

Caplin ME, Mielcarek W, Buscombe JR, Jones AL, Croasdale PL, Cooper MS, et al. Toxicity of high-activity in-111 octreotide therapy in patients with disseminated neuroendocrine tumours. Nucl Med Commun. 2000;21:97–102.PubMedCrossRef

20.

Lafortune M, Madore F, Patriquin H, Breton G. Segmental anatomy of the liver; a US approach to the Couinaud nomenclature. Radiology. 1991;181:443–8.PubMed

21.

Siegel JA, Thomas SR, Stubbs JB, Stabin MG, Hays MT, Koral KF, et al. MIRD pamphlet no. 16: techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates. J Nucl Med. 1999;40:37–61.

22.

Kontogeorgakos D, Dimitriou P, Limouris GS, Vlachos LJ. Patient specific dosimetry calculations during therapy with in-111-DTPA-d-Phe1-octreotide infusions after catheterization of the hepatic artery using mathematical models of different anatomical sizes. J Nucl Med. 2006;47(9):1476–82.PubMed

23.

Therasse P, Arbuck SG, Eienhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumours. J Natl Cancer Inst. 2000;92(30):205–16.PubMedCrossRef

24.

Stabin M. MIRDOSE: the personal computer software for internal dose assessment in nuclear medicine. J Nucl Med. 1996;37:538–46.PubMed

25.

Hellman P, Lundström T, Öhrvall V, Eriksson B, Skogseid B, Öberg K, et al. Effect of surgery on the outcome of midgut carcinoid disease with lymph node and liver metastases. World J Surg. 2002;26:991–97.PubMedCrossRef

26.

Öberg K. Therapeutic alternative in metastasizing neuroendocrine tumours; in carefully selected cases liver transplantation is possible? Laekartidningen. 1999;96:3745–7.

27.

Kress O, Wagner HJ, Wied M, Klose KJ, Arnold R, Alfke H. Transarterial chemoembolization of advanced liver metastases of neuroendocrine tumours; a retrospective single-center analysis. Digestion. 2003;68:94–101.PubMedCrossRef

28.

Dodd GD, Soulen MC, Kane RA, Livraghi T, Lees WR, Yamashita Y, et al. Minimally invasive treatment of malignant hepatic tumours; at the threshold of major breakthrough. Radiographics. 2000;20:9–27.PubMed

29.

Öberg K. Carcinoid tumours: molecular genetics, tumour biology and update of diagnosis and treatment. Curr Opin Oncol. 2002;14:38–45.PubMedCrossRef

30.

Öberg K. Interferon in the management of neuroendocrine GEP-tumours: a review. Digestion 2000;62(Suppl 1):92–7.PubMed

31.

Kaltsas GA, Besser MG, Grossman AB. The diagnosis and medical management of advanced neuroendocrine tumors. Endocr Rev. 2004;25(3):458–511.PubMedCrossRef

32.

Kaltsas GA, Mucherjee JJ, Plowman PN, Grassman AB. The role of chemotherapy in the nonsurgical management of malignant neuroendocrine tumours. Clin Endocrinol. 2001;55:575–87.CrossRef

33.

Wang DG. Apoptosis in neuroendocrine tumours. Clin Endocrinol. 1999;51:1–9.CrossRef

34.

Virgolini I, Britton K, Buscome JR, Moncay R, Paganelli G, Riva P. In- and Y-DOTA lanreotide: results and implications of the Mauritius trial. Semin Nucl Med. 2000;32:148–55.CrossRef

35.

Paganelli G, Zoboli S, Cremonesi M, Bodei L, Ferrari M, Grana C, et al. Receptor-mediated radiotherapy with Y-90-d-Phe¹-Tyr³-octreotide. Eur J Nucl Med. 2001;28:426–34.PubMedCrossRef

36.

Handkiewicz Junak D, Baum R, Jarzab B. Leukocyte and white blood cell toxicity during long-term peptide receptor radiotherapy using Y-90 and Lu-177 labelled somatostatin analogues. Eur J Nucl Med 2005;32(9):S100.

37.

Kwekkeboom DJ, Bakker WH, Kooij PPM, Konijnenberg MW, Srinivasan A, Erion JL, et al. Lu-177-DOTA Tyr octreotate: comparison with In-111-DTPA-octreotide in patients. Eur J Nucl Med. 2001;28:1319–25.PubMedCrossRef

38.

Anthony LB, Woltering EA, Espanan GD, Cronin MD, Maloney TJ, McCarthy KE, et al. Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies. Semin Nucl Med. 2002;32(2):123–32.PubMedCrossRef

39.

Buscombe JR, Caplin ME, Hilson JW. Long-term efficacy of high-activity ¹¹¹In-pentetreotide therapy in patients with disseminated neuroendocrine tumors. J Nucl Med. 2003;44:1–6.PubMed

40.

Förster GJ, Engelbach M, Brockmann J, Reber H, Buchholz H-G, Mäcke HR, et al. Preliminary data on biodistribution and dosimetry for therapy planning of somatostatin receptor positive tumours: comparison of ⁸⁶Y-DOTATOC and ¹¹¹In-DTPA-octreotide. Eur J Nucl Med. 2001;28:1743–50.PubMedCrossRef

41.

Helisch A, Förster GJ, Reber H, Buchholz H-G, Arnold R, Göke B, et al. Pre-therapeutic dosimetry and biodistribution of ⁸⁶Y-DOTA-Phe¹-Tyr³-octreotide versus ¹¹¹In-pentetreotide in patients with advanced neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2004;31(10):1386–92.PubMedCrossRef

42.

Goddu SM, Budinger TF. MIRD: cellular S values. Reston, VA: SNM; 1997.

43.

Buchegger F, Perillo-Adamer F, Dupertuis YM, Bischof Delaloye A. Auger radiation targeted into DNA: a therapy perspective. Eur J Nucl Med Mol Imaging. 2006;33(11):1352–63.PubMedCrossRef

44.

Health Physics J. RADAR; 2008. http://www.doseinfo-radar.com/RADARSoft.html

45.

Limouris GS, Dimitropoulos N, Kontogeorgakos D, Papanikolos G, Koutoulidis V, Hatzioannou A, et al. Evaluation of the therapeutic response to In-111-DTPA octreotide-based targeted therapy in liver metastatic neuroendocrine tumours according to CT/MRI/US findings. Cancer Biother Radiopharm. 2005;20(2):215–7.PubMedCrossRef

46.

Kwekkeboom DJ, Mueller-Brand J, Paganelli G, Anthony LB, Pauwels S, Kvols LK, et al. Overview of results of peptide receptor radionuclide therapy with 3 radiolabeled somatostatin analogs. J Nuclear Med. 2005;46(Suppl 1):62–6.

47.

Bodei L, Cremonesi M, Zoboli S, Grana C, Bartolomei M, Rocca P, et al. Receptor-mediated radionuclide therapy with ⁹⁰Y-DOTATOC in association with amino acid infusion: a phase I study. Eur J Nucl Med. 2003;30:207–16.

48.

Waldherr C, Pless M, Maecke HR, Schumacher T, Crazzolara A, Nitzsche EU, et al. Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq ⁹⁰Y-DOTATOC. J Nucl Med. 2002;43(5):610–6.PubMed

49.

Cremonesi M, Ferrari M, Bodei L, Tosi G, Paganelli G. Dosimetry in peptide radionuclide receptor therapy: a review. J Nucl Med. 2006;47(9):1467–75.PubMed

50.

De Jong M, Valkema R, Van Gameren A, Van Boven H, Bex A, Van de Weyer EP, et al. Inhomogenous localization of radioactivity in the human kidney after injection of [¹¹¹In-DTPA]octreotide. J Nucl Med. 2004;45(7):1168–71.PubMed

Titel: Selective hepatic arterial infusion of In-111-DTPA-Phe1-octreotide in neuroendocrine liver metastases
verfasst von: Georgios S. Limouris
Achilles Chatziioannou
Dimitrios Kontogeorgakos
Dimitrios Mourikis
Maria Lyra
Panagiotis Dimitriou
Anastasia Stavraka
Athanassios Gouliamos
Lambros Vlahos
Publikationsdatum: 01.10.2008
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 10/2008
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-008-0779-0

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Selective hepatic arterial infusion of In-111-DTPA-Phe¹-octreotide in neuroendocrine liver metastases

Abstract

Purpose

Methods

Results

Conclusion

Die Highlights vom Kongress des American College of Cardiology 2024

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 10/2008

Correlation of [18F]FMISO autoradiography and pimonodazole immunohistochemistry in human head and neck carcinoma xenografts

Concordance between results of somatostatin receptor scintigraphy with 111In-DOTA-DPhe1-Tyr3-octreotide and chromogranin A assay in patients with neuroendocrine tumours

Real-time in vivo monitoring of viable stem cells implanted on biocompatible scaffolds

How much CT is needed in nuclear medicine

Section of Nuclear Medicine of the European Union of Medical Specialists (UEMS) and European Board of Nuclear Medicine (EBNM)

Guidelines for radioiodine therapy of differentiated thyroid cancer