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Erschienen in: Der Onkologe 10/2004

01.10.2004 | Leitthema

Peptidrezeptorvermittelte Radiotherapie (PRRT) neuroendokriner Tumoren

Klinische Indikationen und Erfahrung mit 90Yttrium-markierten Somatostatinanaloga

verfasst von: Prof. Dr. R. P. Baum, J. Söldner, M. Schmücking, A. Niesen

Erschienen in: Die Onkologie | Ausgabe 10/2004

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Zusammenfassung

Die radioaktive Markierung spezifischer Peptide, die gezielt an Somatostatinrezeptoren auf neuroendokrinen Tumoren binden, ermöglicht eine interne Strahlentherapie, die unter weitgehender Schonung des gesunden Gewebes (strahlenexponiert wird im Wesentlichen nur die Niere und erheblich weniger das Knochenmark) und meist nur geringer Belastung des Patienten mehrfach durchgeführt wird. Die Radiorezeptortherapie eignet sich besonders für Patienten mit langsam wachsenden hepatischen und extrahepatischen Metastasen bzw. Tumoren, die erfahrungsgemäß für eine Chemotherapie weniger geeignet und bei denen die chirurgischen Möglichkeiten der Tumorresektion erschöpft sind. Auch Patienten, die einen Progress der Erkrankung unter Octreotidtherapie bzw. kombinierter Biotherapie aufweisen, und solche mit ausgeprägter klinischer Symptomatik trotz hoch dosierter Hormontherapie kommen für eine Radiorezeptortherapie in Betracht. Die Behandlungsergebnisse der PRRT aus verschiedenen europäischen Zentren sowie von Multizenterstudien zeigen eine hohe Tumoransprechrate und einen signifikant positiven Effekt auf die klinische Symptomatik.
Literatur
1.
Zurück zum Zitat Anthony LB, Woltering EA, Espenan GD et al. (2002) Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies. Semin Nucl Med 32:123–132PubMed Anthony LB, Woltering EA, Espenan GD et al. (2002) Indium-111-pentetreotide prolongs survival in gastroenteropancreatic malignancies. Semin Nucl Med 32:123–132PubMed
2.
Zurück zum Zitat Bajette E, Ferrari L, Procopio G, Catena L et al. (2002) Efficacy of chemotherapy combination for the treatment of metastatic neuroendocrine tumours. Annals of Oncology 13:614–621CrossRefPubMed Bajette E, Ferrari L, Procopio G, Catena L et al. (2002) Efficacy of chemotherapy combination for the treatment of metastatic neuroendocrine tumours. Annals of Oncology 13:614–621CrossRefPubMed
3.
Zurück zum Zitat Baum RP, Hofmann M (2004) Nuklearmedizinische Diagnostik neuroendokriner Tumore. Onkologe 10:598–610CrossRef Baum RP, Hofmann M (2004) Nuklearmedizinische Diagnostik neuroendokriner Tumore. Onkologe 10:598–610CrossRef
4.
Zurück zum Zitat Baum RP, Soeldner J, Schmuecking M (2004) Clinical results of peptide receptor radionuclide therapy (PRRT) with yttrium-90-DOTA-TYR3-OCTREOTATE (Y-90 DOTA-TATE) in patients with neuroendocrine tumors. J Nucl Med 45:90P Baum RP, Soeldner J, Schmuecking M (2004) Clinical results of peptide receptor radionuclide therapy (PRRT) with yttrium-90-DOTA-TYR3-OCTREOTATE (Y-90 DOTA-TATE) in patients with neuroendocrine tumors. J Nucl Med 45:90P
5.
Zurück zum Zitat Behr TM, Behe M, Kluge G et al. (2002) Nephrotoxicity versus anti-tumour efficacy in radiopeptide therapy: facts and myths about the Scylla and Charybdis. Eur J Nucl Med Mol Imaging 29:277–279CrossRefPubMed Behr TM, Behe M, Kluge G et al. (2002) Nephrotoxicity versus anti-tumour efficacy in radiopeptide therapy: facts and myths about the Scylla and Charybdis. Eur J Nucl Med Mol Imaging 29:277–279CrossRefPubMed
6.
Zurück zum Zitat Boerman OC, Oyen WJ, Corstens FH (2001) Between the Scylla and Charybdis of peptide radionuclide therapy: hitting the tumor and saving the kidney. Eur J Nucl Med 28:1447–1449CrossRefPubMed Boerman OC, Oyen WJ, Corstens FH (2001) Between the Scylla and Charybdis of peptide radionuclide therapy: hitting the tumor and saving the kidney. Eur J Nucl Med 28:1447–1449CrossRefPubMed
7.
Zurück zum Zitat Bushnell D, O‘Dorisio T, Menda Y et al. (2003) Evaluating the clinical effectiveness of Y-90-SMT487 in patients with neuroendocrine tumors. J Nucl Med 44:1556–1560PubMed Bushnell D, O‘Dorisio T, Menda Y et al. (2003) Evaluating the clinical effectiveness of Y-90-SMT487 in patients with neuroendocrine tumors. J Nucl Med 44:1556–1560PubMed
8.
Zurück zum Zitat Chinol M, Bodei L, Cremonesi M, Paganelli G (2002) Receptor-mediated radiotherapy with Y-DOTA-dPhe-Tyr-octreotide: the experience of the European Institute of Oncology Group. Semin Nucl Med 32:141–147PubMed Chinol M, Bodei L, Cremonesi M, Paganelli G (2002) Receptor-mediated radiotherapy with Y-DOTA-dPhe-Tyr-octreotide: the experience of the European Institute of Oncology Group. Semin Nucl Med 32:141–147PubMed
9.
Zurück zum Zitat Cybulla M, Weiner SM, Otte A (2001) End-stage renal disease after treatment with 90Y-DOTATOC. Eur J Nucl Med 28:1552–1554CrossRefPubMed Cybulla M, Weiner SM, Otte A (2001) End-stage renal disease after treatment with 90Y-DOTATOC. Eur J Nucl Med 28:1552–1554CrossRefPubMed
10.
Zurück zum Zitat De Jong M, Breeman WA, Bakker WH et al. (1998) Comparison of 111In-labeled somatostatin analogues for tumor scintigraphy and radionuclide therapy. Cancer Res 58:437–441PubMed De Jong M, Breeman WA, Bakker WH et al. (1998) Comparison of 111In-labeled somatostatin analogues for tumor scintigraphy and radionuclide therapy. Cancer Res 58:437–441PubMed
11.
Zurück zum Zitat De Jong M, Bakker WH, Breeman WA et al. (1998) Pre-clinical comparison of [DTPA0] octreotide, [DTPA0,Tyr3] octreotide and [DOTA0,Tyr3] octreotide as carriers for somatostatin receptor-targeted scintigraphy and radionuclide therapy. Int J Cancer 75:406–411CrossRefPubMed De Jong M, Bakker WH, Breeman WA et al. (1998) Pre-clinical comparison of [DTPA0] octreotide, [DTPA0,Tyr3] octreotide and [DOTA0,Tyr3] octreotide as carriers for somatostatin receptor-targeted scintigraphy and radionuclide therapy. Int J Cancer 75:406–411CrossRefPubMed
12.
Zurück zum Zitat De Jong M, Breeman WAP, Bernard HF et al. (2001) Receptor-targeted radionuclide therapy using radiolabelled somatostatin analogues: tumour size versus curability. Eur J Nucl Med 28:1026P De Jong M, Breeman WAP, Bernard HF et al. (2001) Receptor-targeted radionuclide therapy using radiolabelled somatostatin analogues: tumour size versus curability. Eur J Nucl Med 28:1026P
13.
Zurück zum Zitat De Jong M, Breeman WA, Bernard BF et al. (2001) Tumor response after [90Y-DOTA(0),Tyr(3)]octreotide radionuclide therapy in a transplantable rat tumor model is dependent on tumor size. J Nucl Med 42:1841–1846PubMed De Jong M, Breeman WA, Bernard BF et al. (2001) Tumor response after [90Y-DOTA(0),Tyr(3)]octreotide radionuclide therapy in a transplantable rat tumor model is dependent on tumor size. J Nucl Med 42:1841–1846PubMed
14.
Zurück zum Zitat De Jong M, Breeman WA, Bernard BF et al. (2001) [177Lu-DOTA(0),Tyr3] octreotate for somatostatin receptor-targeted radionuclide therapy. Int J Cancer 92:628–633CrossRefPubMed De Jong M, Breeman WA, Bernard BF et al. (2001) [177Lu-DOTA(0),Tyr3] octreotate for somatostatin receptor-targeted radionuclide therapy. Int J Cancer 92:628–633CrossRefPubMed
15.
Zurück zum Zitat De Jong M, Valkema R, Jamar F et al. (2002) Somatostatin receptor-targeted radionuclide therapy of tumors: preclinical and clinical findings. Semin Nucl Med 32:133–140CrossRefPubMed De Jong M, Valkema R, Jamar F et al. (2002) Somatostatin receptor-targeted radionuclide therapy of tumors: preclinical and clinical findings. Semin Nucl Med 32:133–140CrossRefPubMed
16.
Zurück zum Zitat De Jong M, Bernard HF, Breeman WAP et al. (2002) Combination of 90Y- and 177Lu-labeled somatostatin analogs is superior for radionuclide therapy compared to 90Y- or 177Lu-labeled analogs only. J Nucl Med 43:123P-124P De Jong M, Bernard HF, Breeman WAP et al. (2002) Combination of 90Y- and 177Lu-labeled somatostatin analogs is superior for radionuclide therapy compared to 90Y- or 177Lu-labeled analogs only. J Nucl Med 43:123P-124P
17.
Zurück zum Zitat De Jong M, Kwekkeboom D, Valkema R, Krenning EP (2003) Radiolabelled peptides for tumor therapy: current status and future directions. Eur J Nucl Med 30:463–469 De Jong M, Kwekkeboom D, Valkema R, Krenning EP (2003) Radiolabelled peptides for tumor therapy: current status and future directions. Eur J Nucl Med 30:463–469
18.
Zurück zum Zitat Hejna M, Schmidinger M, Raderer M (2002) The clinical role of somatostatin analogues as antineoplastic agents: much ado about nothing? Annals of Oncology 13:653–668CrossRefPubMed Hejna M, Schmidinger M, Raderer M (2002) The clinical role of somatostatin analogues as antineoplastic agents: much ado about nothing? Annals of Oncology 13:653–668CrossRefPubMed
19.
Zurück zum Zitat Heppeler A, Froidevaux S, Maecke HR et al. (1999) Radiometal-labelled macrocyclic chelator-derivatised somatostatin analogue with superb tumour-targeting properties and potential for receptor-mediated internal radiotherapy. Chem Eur J 5:1974–1981CrossRef Heppeler A, Froidevaux S, Maecke HR et al. (1999) Radiometal-labelled macrocyclic chelator-derivatised somatostatin analogue with superb tumour-targeting properties and potential for receptor-mediated internal radiotherapy. Chem Eur J 5:1974–1981CrossRef
20.
Zurück zum Zitat Jamar F, Barone R, Mathieu I et al. (2003) Y-86-DOTA0-D-Phe1-Tyr3-octreotide (SMT487)—a phase 1 clinical study: pharmacokinetics, biodistribution and renal protective effect of different regimes of amino acid co-infusion. Eur J Nucl Med Mol Imaging 30:510–518PubMed Jamar F, Barone R, Mathieu I et al. (2003) Y-86-DOTA0-D-Phe1-Tyr3-octreotide (SMT487)—a phase 1 clinical study: pharmacokinetics, biodistribution and renal protective effect of different regimes of amino acid co-infusion. Eur J Nucl Med Mol Imaging 30:510–518PubMed
21.
Zurück zum Zitat Jonard P, Jamar F, Walrand S et al. (2000) Tumor dosimetry based on PET86Y-DOTA-Tyr3-octreotide (SMT487) and CT-scan predicts tumor response to 90Y-SMT487 (OctreoTher). J Nucl Med 41:111P Jonard P, Jamar F, Walrand S et al. (2000) Tumor dosimetry based on PET86Y-DOTA-Tyr3-octreotide (SMT487) and CT-scan predicts tumor response to 90Y-SMT487 (OctreoTher). J Nucl Med 41:111P
22.
Zurück zum Zitat Kwekkeboom DJ, Kooij PP, Bakker WH et al. (1999) Comparison of 111In-DOTA-Tyr3-octreotide and 111In-DTPA-octreotide in the same patients: biodistribution, kinetics, organ and tumor uptake. J Nucl Med 40:762–767PubMed Kwekkeboom DJ, Kooij PP, Bakker WH et al. (1999) Comparison of 111In-DOTA-Tyr3-octreotide and 111In-DTPA-octreotide in the same patients: biodistribution, kinetics, organ and tumor uptake. J Nucl Med 40:762–767PubMed
23.
Zurück zum Zitat Kwekkeboom D, Krenning EP, de Jong M et al. (2000) Peptide receptor imaging and therapy. J Nucl Med 41:1704–1713PubMed Kwekkeboom D, Krenning EP, de Jong M et al. (2000) Peptide receptor imaging and therapy. J Nucl Med 41:1704–1713PubMed
24.
Zurück zum Zitat Kwekkeboom DJ, Bakker WH, Kooij PPM et al. (2001) [177Lu-DOTA0,Tyr3] octreotate: comparison with [111In-DTPA0] octreotide in patients. Eur J Nucl Med 28:1319–1325CrossRefPubMed Kwekkeboom DJ, Bakker WH, Kooij PPM et al. (2001) [177Lu-DOTA0,Tyr3] octreotate: comparison with [111In-DTPA0] octreotide in patients. Eur J Nucl Med 28:1319–1325CrossRefPubMed
25.
Zurück zum Zitat Lewis JS, Lewis MR, Srinivasan A (1999) Comparison of four 64Cu-labeled somatostatin analogues in vitro and in a tumor-bearing rat model: Evaluation of new derivatives for positron emission tomography imaging and targeted radiotherapy. J Med Chem 42:1341–1347CrossRefPubMed Lewis JS, Lewis MR, Srinivasan A (1999) Comparison of four 64Cu-labeled somatostatin analogues in vitro and in a tumor-bearing rat model: Evaluation of new derivatives for positron emission tomography imaging and targeted radiotherapy. J Med Chem 42:1341–1347CrossRefPubMed
26.
Zurück zum Zitat Paganelli G, Zoboli S, Cremonesi M et al. (2001) Receptor-mediated radiotherapy with 90Y-DOTA-d-Phe1-Tyr3-octreotide. Eur J Nucl Med 28:426–434CrossRefPubMed Paganelli G, Zoboli S, Cremonesi M et al. (2001) Receptor-mediated radiotherapy with 90Y-DOTA-d-Phe1-Tyr3-octreotide. Eur J Nucl Med 28:426–434CrossRefPubMed
27.
Zurück zum Zitat Reubi JC, Schar JC, Waser B (2000) Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 27:273–282CrossRefPubMed Reubi JC, Schar JC, Waser B (2000) Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 27:273–282CrossRefPubMed
28.
Zurück zum Zitat Rolleman EJ, Valkema R, de Jong M et al. (2003) Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine. Eur J Nucl Med Mol Imaging 30:915CrossRef Rolleman EJ, Valkema R, de Jong M et al. (2003) Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine. Eur J Nucl Med Mol Imaging 30:915CrossRef
29.
Zurück zum Zitat Schmitt JS, Wild D, Ginj M et al. (2001) DOTA-NOC, a high affinity ligand of the somatostatin receptor subtypes 2, 3 and 5 for radiotherapy. J Labelled Cpd Radiopharm 44:s697–s699 Schmitt JS, Wild D, Ginj M et al. (2001) DOTA-NOC, a high affinity ligand of the somatostatin receptor subtypes 2, 3 and 5 for radiotherapy. J Labelled Cpd Radiopharm 44:s697–s699
30.
Zurück zum Zitat Valkema R, De Jong M, Bakker WH et al. (2002) Phase I study of peptide receptor radionuclide therapy with [In-DTPA]octreotide: the Rotterdam experience. Semin Nucl Med 32:110–122CrossRefPubMed Valkema R, De Jong M, Bakker WH et al. (2002) Phase I study of peptide receptor radionuclide therapy with [In-DTPA]octreotide: the Rotterdam experience. Semin Nucl Med 32:110–122CrossRefPubMed
31.
Zurück zum Zitat Valkema R, Kvols L, Jamar F et al. (2002) Phase 1 study of therapy with 90Y-SMT487 (OctreoTher) in patients with somatostatin receptor-positive tumors. J Nucl Med 43:33P Valkema R, Kvols L, Jamar F et al. (2002) Phase 1 study of therapy with 90Y-SMT487 (OctreoTher) in patients with somatostatin receptor-positive tumors. J Nucl Med 43:33P
32.
Zurück zum Zitat Virgolini I, Szilvasi I, Kurtaran A et al. (1998) Indium-111-DOTA-lanreotide: biodistribution, safety and radiation absorbed dose in tumor patients. J Nucl Med 39:1928–1936PubMed Virgolini I, Szilvasi I, Kurtaran A et al. (1998) Indium-111-DOTA-lanreotide: biodistribution, safety and radiation absorbed dose in tumor patients. J Nucl Med 39:1928–1936PubMed
33.
Zurück zum Zitat Virgolini I, Patri P, Novotny C, Traub T et al. (2001) Comparative somatostatin receptor scintigraphy using In-111-DOTA-lanreotide and In-111-DOTA-Tyr3-octreotide versus F-18-FDG-PET for evaluation of somatostatin receptor-mediated radionuclide therapy. Ann Oncol 12 (Suppl 2):S41-S45CrossRefPubMed Virgolini I, Patri P, Novotny C, Traub T et al. (2001) Comparative somatostatin receptor scintigraphy using In-111-DOTA-lanreotide and In-111-DOTA-Tyr3-octreotide versus F-18-FDG-PET for evaluation of somatostatin receptor-mediated radionuclide therapy. Ann Oncol 12 (Suppl 2):S41-S45CrossRefPubMed
34.
Zurück zum Zitat Virgolini I, Britton K, Buscombe J et al. (2002) In- and Y-DOTA-lanreotide: results and implications of the MAURITIUS trial. Semin Nucl Med 32:148–155CrossRefPubMed Virgolini I, Britton K, Buscombe J et al. (2002) In- and Y-DOTA-lanreotide: results and implications of the MAURITIUS trial. Semin Nucl Med 32:148–155CrossRefPubMed
35.
Zurück zum Zitat Waldherr C, Pless M, Maecke HR et al. (2001) The clinical value of [90Y-DOTA]-d-Phe1-Tyr3-octreotide (90Y-DOTATOC) in the treatment of neuroendocrine tumours: a clinical phase II study. Ann Oncol 12:941–945CrossRefPubMed Waldherr C, Pless M, Maecke HR et al. (2001) The clinical value of [90Y-DOTA]-d-Phe1-Tyr3-octreotide (90Y-DOTATOC) in the treatment of neuroendocrine tumours: a clinical phase II study. Ann Oncol 12:941–945CrossRefPubMed
36.
Zurück zum Zitat Waldherr C, Pless M, Maecke HR (2002) Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq90Y-DOTATOC. J Nucl Med 43:610–616PubMed Waldherr C, Pless M, Maecke HR (2002) Tumor response and clinical benefit in neuroendocrine tumors after 7.4 GBq90Y-DOTATOC. J Nucl Med 43:610–616PubMed
37.
Zurück zum Zitat Waldherr C, Schumacher T, Maecke HR (2002) Does tumor response depend on the number of treatment sessions at constant injected dose using90Yttrium-DOTATOC in neuroendocrine tumors? Eur J Nucl Med 29:S100 Waldherr C, Schumacher T, Maecke HR (2002) Does tumor response depend on the number of treatment sessions at constant injected dose using90Yttrium-DOTATOC in neuroendocrine tumors? Eur J Nucl Med 29:S100
38.
Zurück zum Zitat Weiner RE, Thakur ML (2002) Radiolabeled peptides in the diagnosis and therapy of oncological diseases. Appl Radiat Isot 57:749–763CrossRefPubMed Weiner RE, Thakur ML (2002) Radiolabeled peptides in the diagnosis and therapy of oncological diseases. Appl Radiat Isot 57:749–763CrossRefPubMed
39.
Zurück zum Zitat Wild D, Schmitt JS, Ginj M et al. (2003) DOTA-NOC, a high-affinity ligand of somatostatin receptor subtypes 2, 3 and 5 for labelling with various radiometals. Eur J Nucl Med Mol Imaging 30:1338–1347CrossRefPubMed Wild D, Schmitt JS, Ginj M et al. (2003) DOTA-NOC, a high-affinity ligand of somatostatin receptor subtypes 2, 3 and 5 for labelling with various radiometals. Eur J Nucl Med Mol Imaging 30:1338–1347CrossRefPubMed
40.
Zurück zum Zitat Wiseman GA, Kvols LK (1995) Therapy of neuroendocrine tumors with radiolabeled MIBG and somatostatin analogues. Semin Nucl Medicine 25:272–278 Wiseman GA, Kvols LK (1995) Therapy of neuroendocrine tumors with radiolabeled MIBG and somatostatin analogues. Semin Nucl Medicine 25:272–278
Metadaten
Titel
Peptidrezeptorvermittelte Radiotherapie (PRRT) neuroendokriner Tumoren
Klinische Indikationen und Erfahrung mit 90Yttrium-markierten Somatostatinanaloga
verfasst von
Prof. Dr. R. P. Baum
J. Söldner
M. Schmücking
A. Niesen
Publikationsdatum
01.10.2004
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 10/2004
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-004-0771-7

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