[177Lu – DOTA – Tyr3] – OCTREOTATE para el tratamiento de tumores neuroendocrinos gastroenteropancreáticos. Revisión sistemática de la literatura.


Autoria(s): Herrera Malo, Yariela Edith; Arévalo Leal, José Sinay; Mejía López, Arturo
Contribuinte(s)

Arévalo Leal, José Sinay

Morón Duarte, Lina Sofía

Data(s)

22/11/2013

Resumo

Introducción: los tumores neuroendocrinos gastroenteropancreáticos se diagnostican en estadio avanzado en 60 - 80% de los pacientes y las opciones terapéuticas son limitadas. Se realizó una revisión sobre el beneficio clínico del tratamiento con [177Lu - DOTA - Tyr3] - Octreotate en pacientes con enfermedad metastásica o inoperable. Objetivos: evaluar la eficacia, impacto en calidad de vida y toxicidad de la terapia con 177Lu DOTATE en pacientes con tumores neuroendocrinos gastroenteropancreáticos avanzados. Materiales y Métodos: se condujo una revisión sistemática de la literatura mediante la búsqueda de estudios clínicos prospectivos y retrospectivos en bases electrónicas (MEDLINE, EMBASE, LILACS, SCIELO, OVID y la Biblioteca Cochrane) de cualquier idioma, año y estado de publicación. Se incluyeron 5 estudios, por la heterogeneidad existente entre los estudios no se realizó un metaanálisis. Resultados: la respuesta tumoral global fue del 45 - 57%, la enfermedad permaneció estable en 27% - 38% y progresó en 6% - 21% de casos en las series incluidas. El tiempo libre de progresión osciló entre 31 - 40 meses y la sobrevida global de 31– 51 meses. Se observó toxicidad hematológica grado 3-4 hasta en 9.5% de pacientes. Hubo mejoría significativa en la calidad de vida de pacientes tratados con 177LuDOTATATE. Conclusiones: la terapia con 177Lu- DOTATATE ofrece un beneficio clínico a los pacientes con tumores neuroendocrinos bien diferenciados avanzados por su impacto positivo en calidad de vida, control de síntomas, ralentiza la progresión tumoral y su toxicidad es baja.

Gastroenteropancreatic neuroendocrine tumors are diagnosed in advanced state in approximately 60 – 80% of patients, their treatment options are limited. We reviewed the clinical benefit of radionuclide therapy with 177Lu – DOTA – Tyr3] – Octreotate in patients with advanced or inoperable disease. Objective: To assess the efficacy, impact on quality of life and side effects of therapy with 177Lu DOTATE in patients with advanced gastroenteropancreatic neuroendocrine tumors. Materials and Methods: We conducted a systematic review using a peer – reviewed search for clinical prospective and retrospective trials. This search was done in electronic databases (MEDLINE, EMBASE, LILACS, SCIELO, OVID and the Cochrane Library) without language, year or publication status limitations. We included 5 studies; because they were heterogeneous no meta analysis was done. Results: Overall tumor response was seen in 45- 57% of cases, stable disease in 27-38% and progression in 6-21% of cases included in the studies. Time to progression was 31 - 40 months and overall survival 31 – 51 months. Hematologic toxicity grade 3-4 presented in up to 9.5% of patients. Treatment had a significant positive impact in quality of life. Conclusions: Therapy with 177Lu- DOTATATE offers a clinical benefit to patients with advanced gastroenteropancreatic neuroendocrine tumors by improving quality of life, controlling symptoms and limiting progression of disease. The toxicity of the drug is low.

Formato

application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/4835

Idioma(s)

spa

Publicador

Facultad de Medicina

Direitos

info:eu-repo/semantics/openAccess

Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

1. Modlin I, Oberg K, Chung D. Gastroentroenteropancreatic neuroendocrine tumors. Lancet Oncol 2008; 9: 61-72

2. Capdevila J, Argilés G, Mulet – Margalef N. Tumores neuroendocrinos: la era de las terapias dirigidas. Endocrinol Nutr 2012; 59:438-451

3. Kam B, Teunissen J, Krenning E. Lutetium – labelled peptides for therapy of neuroendocrine tumors. Eur J Nucl Med Mol Imaging 2012; 39: 103-112

4. Kunikowska J, Królicki L, Hubalewska – Dydejczyck A. Clinical results of radionuclide therapy of neuroendocrine tumor with 90Y-DOTATE and tandem 90Y/177Lu DOTATE: wich is better option? Eur J Nucl Med Mol Imaging 2011; 38: 1788-1797

5. Claringbold P, Price R, Harvey J. Phase I-II study of Radiopeptide 177Lu- Octreotate in combination with capecitabine and temozolamide in advanced low grade neuroendocrine tumors. Cancer Biother Radiopharm 2012; 27:561- 569

6. Kwekkeboom D, de Herdeer W, Kam B. Treatment with the radiolabeled somatostatin analog [177Lu –DOTA, Tyr3]Octreotate: Toxicity, Efficacy and Survival. J Clin Oncol 2008; 26: 2124 – 2130

7. Gulenchyn KY, Yao X, Asa SL. Radionuclide therapy in Neuroendocrine tumours: a systematic review. Clinical Oncology 2012; 24: 294 - 308

8. Müller C, Forrer F, Bernard B. Diagnostic versus therapeutic doses of [177Lu –DOTA, Tyr3]Octreotate: Uptake and Dosimetry somatostatin receptor positive tumors and normal organs. Cancer Biother & Radiopharm 2007; 22: 151 - 159

9. Öberg, Kjell. Neuroendocrine gastrointestinal and lung tumors (carcinoid tumors), carcinoid síndrome and related disorders. Williams Textbook of Endocronology. 12th Edition; 1809 – 1828

10. Jong M, Valkema R, Jamar F. Somatostatin Receptor – Targeted Radionuclide Therapy of tumors: preclinical and clinical findings. Seminars in Nuclear Medicine 2002; 32: 133-140

11. Bodei K, Cremonesi M, Grana Ch. Peptide receptor radionuclide therapy with 177Lu – DOTATATE: the IEO phase I-II study. Eur J Nucl Med Mol Imaging 2011; 38: 2125 – 2135

12. Kwekkeboom D, de Herdeer W, Krenning E. Somatostatin Receptor Targeted Radionuclide in Patients with Gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin N Am 2011; 40: 173 – 185

13. Garkavij M, Nickel M, Sjögreen – Gleisner K. [177Lu –DOTA, Tyr3]Octreotate therapy in patients with disseminated neuroendocrine tumors: analysis of dosimetry with impacto n future therapeutic strategy. Cancer 2010; 116: 1084 – 1092

14. Swärd C, Bernhardt P, Ahlman H. [177Lu –DOTA, Tyr3]Octreotate treatment in patients with disseminated gastreoenteropancreatic neuroendocrine tumors: the value of measuring absorbed dose to the kidney. World J Surg 2010; 34: 1368 – 1372

15. Teunissen J, Kwekkeboom D, Krenning E. Quality of life in patients with gastroenteropancreatic tumors treated with [177Lu –DOTA, Tyr3]Octreotate. J Clin Oncol 2004; 22:2724- 2729

16. Khan S, Krenning E, van Essen M. Quality of life in 265 patients with gastroenteropancreatic or bronchial neuroendocrine tumors treated with [177Lu –DOTA, Tyr3]Octreotate. J Nucl Med 2011; 52: 1361 – 1368

17. NCT01578239. A study comparing the treatment with 177Lu DOTA 0 Tyr3 Octreotate to octreotide long acting reléase in patients with inoperable, progressive somatostatin receptor positive midgut carcinoid tumour. www.clinicaltrials.gov

18. NCT01860742. Randomised phase III of Peptide receptor radionuclie therapy. www.clinicaltrials.gov

19. Sansovini M, Severi S, Ambrosetti A. Treatment with the radiolabelled somatostatin analog 177Lu-DOTATATE for advanced pancreatic neuroendocrine tumours. Neuroendocrinology 2013; 97: 347-354

20. van Essen M, Krenning E, Kam B. Salvage therapy with 177Lu Octreotate in patients with bronchial and gastroenteropancreatic neuroendocrine tumors. J Nucl Med 2010; 51: 383-390

21. Esser JP, Krenning EP, Teunissen JJM. Comparison of 177Lu DOTA0 Tyr3 octreotate and 177Lu DOTA0 Tyr3 octreotide, wich peptide is preferable for PRRT. Eur J Nucl Med Mol Imaging (2006) 33: 1346-1351

22. Keizer B, van Aken M, Feckers R. Hormonal crises following therapy with the radiolabeled somatostatin analog 177Lu DOTA0 Tyr3 octreotate. Eur J Nucl Med Mol Imaging 2008; 35: 747-755

23. Valkema R, Pauwels S, Kvols L. Long term follow up of renal function after peptide receptor radionuclide therapy with 90Y DOTA0 Tyr3 octreotate and 177Lu DOTA0 Tyr3 octreotate. J Nucl Med 2005; 46: 835-915

24. Kunilowska J, Królicki L, Sowa-Staszczak A. Polish experience in peptide receptor radionuclide therapy. Theranostics, Gallium 68 and other Radionuclides. Recent Results in Cancer Research 2013;194: 467 -478

25. Claringbold P, Braysahaw P, Price R. Phase II study of radiopeptide 177Lu- Octreotate and capecitabine therapy of progressive disseminated neuroendocrine tumor. Eur J Nucl Med Mol Imaging 2011; 38: 302-311

26. Ezziddin S, Sabet A, Heinemann F. Response and Long Term control of bone metastases after peptide receptor radionuclide therapy with 177Lu- Octreotate. J Nucl Med 2011; 52: 1197-1203.

27. Öberg K. Neuroendocrine tumors of the digestive tract impact of new classification and new agents on therapeutic approaches. Curr Opin Oncol 2012; 24:433 - 440

28. Pavel ME, Hainsworth JD, Baudin E. Everolimus plus octreotide long acting repeatable for the treatment of advanced neuroendocrine tumours associated with carcinoid síndrome (RADIANT – 2): A randomized, placebo controlled phase 3 study. Lancet 2011; 378: 2005- 2012

29. Strosberg J, Fine RL, Choi J. First line chemotherapy with capecitabine and temozolamide in patients with metastatic pancreatic endocrine carcinomas. Cancer 2011; 117: 269 - 275.

Palavras-Chave #CARCINOMA NEUROENDOCRINO #MEDICINA NUCLEAR - INVESTIGACIONES #NEOPLASIAS PANCREÁTICAS #OCTREÓTIDO - UTILIZACIÓN #TUMORES NEUROENDOCRINOS - DIAGNÓSTICO #TUMORES NEUROENDOCRINOS - TRATAMIENTO #177Lu- DOTATATE #177Lu-octreotate #gastroenteropancreatic neuroendocrine tumor
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/acceptedVersion