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European Journal of Nuclear Medicine and Molecular Imaging

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01.11.2006 | Original article

Comparison of [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate and [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotide: which peptide is preferable for PRRT?

verfasst von: J. P. Esser, E. P. Krenning, J. J. M. Teunissen, P. P. M. Kooij, A. L. H. van Gameren, W. H. Bakker, D. J. Kwekkeboom

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2006

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Abstract

Purpose

Patients with somatostatin receptor subtype 2-positive metastasised neuroendocrine tumours can be treated with [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate. Some use octreotide as the peptide for peptide receptor radionuclide therapy (PRRT). We compared in seven patients [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotide (¹⁷⁷Lu-DOTATOC) and [¹⁷⁷Lu-DOTA⁰,Tyr³]octreotate (¹⁷⁷Lu-DOTATATE), to see which peptide should be preferred for PRRT with ¹⁷⁷Lu.

Methods

In the same patients, 3,700 MBq ¹⁷⁷Lu-DOTATOC and 3,700 MBq ¹⁷⁷Lu-DOTATATE was administered in separate therapy sessions. Amino acids were co-administered. Whole-body scanning was performed on days 1, 4 and 7 post therapy. Blood and urine samples were collected. We calculated residence times for tumours, spleen and kidneys.

Results

All patients had longer residence times in spleen, kidneys and tumours after use of ¹⁷⁷Lu-DOTATATE (p=0.016 in each case). Comparing ¹⁷⁷Lu-DOTATATE with ¹⁷⁷Lu-DOTATOC, the mean residence time ratio was 2.1 for tumour, 1.5 for spleen and 1.4 for kidneys. Dose-limiting factors for PRRT are bone marrow and/or kidney dose. Although the residence time for kidneys was longer when using ¹⁷⁷Lu-DOTATATE, the mean administered dose to tumours would still be advantageous by a factor of 1.5, assuming a fixed maximum kidney dose is reached. Plasma radioactivity after ¹⁷⁷Lu-DOTATATE was comparable to that after ¹⁷⁷Lu-DOTATOC. Urinary excretion of radioactivity was comparable during the first 6 h; thereafter there was a significant advantage for ¹⁷⁷Lu-DOTATOC.

Conclusion

¹⁷⁷Lu-DOTATATE had a longer tumour residence time than ¹⁷⁷Lu-DOTATOC. Despite a longer residence time in kidneys after ¹⁷⁷Lu-DOTATATE, tumour dose will always be higher. Therefore, we conclude that the better peptide for PRRT is octreotate.

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Titel: Comparison of [177Lu-DOTA0,Tyr3]octreotate and [177Lu-DOTA0,Tyr3]octreotide: which peptide is preferable for PRRT?
verfasst von: J. P. Esser
E. P. Krenning
J. J. M. Teunissen
P. P. M. Kooij
A. L. H. van Gameren
W. H. Bakker
D. J. Kwekkeboom
Publikationsdatum: 01.11.2006
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2006
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-006-0172-9

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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