Treatment of Metastatic Carcinoid Tumors With Radiolabeled Biologic Molecules

Author:
David BushnellIowa City VAMC, University of Iowa Hospitals and Clinics, Iowa City, Iowa

Search for other papers by David Bushnell in
Current site
Google Scholar
PubMed
Close
 MD
Full access

Treatment options in advanced-stage neuroendocrine tumors are limited. A promising new category of therapy was recently introduced for these tumors in which radioactive atoms are attached to molecules that target and bind to neuroendocrine cancer cells. 90Yttrium-DOTA-Phe1-Tyr3-octreotide and radioactive drugs which targets cells by binding to somatostatin receptors. 131Iodine-metaiodobenzylguanidine also targets neuroendocrine tumors using the amine transporter system. Both agents, along with the somatostatin analogue 177Lutetium-DOTATATE, have shown objective response rates in approximately 30% of patients with progressive metastatic disease. Symptomatic improvement is observed in most patients receiving these drugs and evidence of survival benefit is also mounting. Serious side effects are uncommon.

Correspondence: David Bushnell, MD, Professor of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242. E-mail: david-bushnell@uiowa.edu
  • Collapse
  • Expand
  • 1

    de Jong M, Kwekkeboom D, Valkema R et al.. Radiolabeled peptides for tumour therapy: current status and future directions. Eur J Nucl Med Mol Imaging 2003;30:463469.

    • Search Google Scholar
    • Export Citation
  • 2

    Kwekkeboom DJ, Mueller-Brand J, Paganelli G et al.. Overview of results of peptide receptor radionuclide therapy with 3 radiolabeled somatostatin analogs. J Nucl Med 2005;46(Suppl 1):62S66S.

    • Search Google Scholar
    • Export Citation
  • 3

    Paganelli G, Zoboli S, Cremonesi M et al.. Receptor mediated radionuclide therapy with 90Y-DOTA-D-phe1-try3-octreotide: Preliminary report in Cancer patients. Cancer Biother Radiopharm 1999;14:477483.

    • Search Google Scholar
    • Export Citation
  • 4

    Bushnell D, O’Dorisio T, Menda T et al.. Evaluating the clinical effectiveness of 90Y-SMT-487 in patients with neuroendocrine tumors. J Nucl Med 2003;44:15561560.

    • Search Google Scholar
    • Export Citation
  • 5

    Waldherr C, Pless M, Maecke HR et al.. Tumor response and clinical benefit in neuroendocrine tumors after 7.4 Gbq 90Y-DOTATOC. J Nucl Med 2002;43:610616.

    • Search Google Scholar
    • Export Citation
  • 6

    Tuenissen JJM, Kwekkeboom DJ, Krenning EP. Quality of life in patients with gastroenteropancreatic tumors treated with 177Lu-DOTA-octreotate. J Clin Oncol 2004;22:27242729.

    • Search Google Scholar
    • Export Citation
  • 7

    Hörsch D, Prasad V, Baum RP. Longterm outcome of peptide receptor radionuclide therapy (PRRT) in 454 patients with progressive neuroendocrine tumors using yttrium-90 and lutetium-177 labelled somatostatin receptor targeting peptides [abstract]. J Clin Oncol 2008;26(Suppl 1):Abstract 4517.

    • Search Google Scholar
    • Export Citation
  • 8

    Valkema R, Pauwels S, Kvols LK et al.. Survival and response after peptide receptor radionuclide therapy with [90Y-DOTA0,Tyr3] Octreotide in patients with advanced gastroenteropancreatic neuroendocrine tumors. Semin Nucl Med 2006;36:147156.

    • Search Google Scholar
    • Export Citation
  • 9

    McCarthy KE, Powers A, Lemen L et al.. Dosimetry of 111In-pentetreotide predicts response to high dose radiotherapy with somatostatin analogs in patients with gastropancreatic tumors. J Nucl Med 2002;43:34P.

    • Search Google Scholar
    • Export Citation
  • 10

    de Jong M, Breeman WAP, Valkema R et al.. Combination radionuclide therapy using 177Lu and 90Y labeled somatostatin analogs. J Nucl Med 2005;46(Suppl 1):13S17S.

    • Search Google Scholar
    • Export Citation
  • 11

    Valkema R, Pauwels S, Kvols L et al.. Long term follow-up of renal function after peptide receptor radiation therapy with 90Y DOTA-try3-octreotide and 177Lu DOTA-try3-octreotate. J Nucl Med 2005;46:8391.

    • Search Google Scholar
    • Export Citation
  • 12

    de Jong M, Krenning E. New advances in peptide receptor radionuclide therapy. J Nucl Med 2002;43:617625.

  • 13

    Jamar F, Barone R Mathieu I et al.. 86Y-DOTA-D-Phe1-Try3-octreotide (SMT487) - a phase 1 clinical study: pharmacokinetics, biodistribution and renal protective effect of different regimens of amino acid co-infusion. Eur J Nucl Med Mol Imaging 2003;30:510518.

    • Search Google Scholar
    • Export Citation
  • 14

    Bushnell D, Menda Y, O’Dorisio T et al.. Effects of intravenous amino acid administration with Y-90 DOTA-Phe1-Tyr3-Octreotide (SMT487 [OctreoTher™]) treatment. Cancer Biother Radiopharm 2004;19;3545.

    • Search Google Scholar
    • Export Citation
  • 15

    Rolleman EJ, Valkema R, de Jong M et al.. Safe and effective inhibition of renal uptake of radiolabeled octreotide by a combination of lysine and arginine. Eur J Nucl Med Mol Imaging 2003;30:915.

    • Search Google Scholar
    • Export Citation
  • 16

    Barone R, Boroson-Chazot F, Valkema R et al.. Patient specific dosimetry in predicting renal toxicity with 90Y-DOTATOC: relevance of kidney volume and dose rate in finding a dose-effect relationship. J Nucl Med 2005;46(Suppl 1):99106.

    • Search Google Scholar
    • Export Citation
  • 17

    Bomanji JB, Wong W, Gaze MN et al.. Treatment of neuroendocrine tumours in adults with 131I-MIBG therapy. Clin Oncol (R Coll Radiol) 2003;15:193198.

    • Search Google Scholar
    • Export Citation
  • 18

    Safford SD, Coleman RE, Gockerman JP et al.. Iodine-131 metaiodobenzylguanidine treatment for metastatic carcinoid. Results in 98 patients. Cancer 2004;101:19871993.

    • Search Google Scholar
    • Export Citation
  • 19

    Madsen M, Bushnell D, Juweid M et al.. Potential increased tumor-dose delivery with combined 131I and 90Y DOTATOC treatment in neuroendocrine tumors: a theoretic model. J Nucl Med 2006;47;660667.

    • Search Google Scholar
    • Export Citation
  • 20

    Taal BG, Hoefnagel CA, Valdes Olmos RA, Boot H. Combined diagnostic imaging with 131I-metaiodobenzylguanidine and 111In-pentetreotide in carcinoid tumours. Eur J Cancer 1996;32A:19241932.

    • Search Google Scholar
    • Export Citation
  • 21

    Kaltsas G, Korbonits M, Heintz E et al.. Comparison of somatostatin analog and meta-iodobenzylguanidine radionuclides in the diagnosis and localization of advanced neuroendocrine tumors. J Clin Endocrinol Metab 2001;86:895902.

    • Search Google Scholar
    • Export Citation
  • 22

    Quigley AM, Buscombe JR, Shah T et al.. Intertumoural variability in functional imaging within patients suffering from neuroendocrine tumours. An observational, cross-sectional study. Neuroendocrinology 2005;82:215220.

    • Search Google Scholar
    • Export Citation
  • 23

    Quigley AM, Buscombo JR, Gopinath G et al.. In-vivo characterisation of the functional aspects of carcinoid tumors by imaging somatostatin receptors and amine uptake [abstract]. J Nucl Med 2003;44:Abstract 74P.

    • Search Google Scholar
    • Export Citation
  • 24

    O’Donoghue JA, Bardies M, Wheldon TE. Relationships between tumor size and curability for uniformly targeted therapy with beta-emitting radionuclides. J Nucl Med 1995;36:19021909.

    • Search Google Scholar
    • Export Citation
  • 25

    Gaze MN, Mairs RJ, Boyack SM et al.. 131I-meta-iodobenzylguanidine therapy in neuroblastoma spheroids of different sizes. Br J Cancer 1992;66:10481052.

    • Search Google Scholar
    • Export Citation
  • 26

    de Jong M, Breeman WA, Bernard BF et al.. Tumor response after [(90)Y-DOTA(0),Tyr(3)]octreotide radionuclide therapy in a transplantable rat tumor model is dependent on tumor size. J Nucl Med 2001;42:18411846.

    • Search Google Scholar
    • Export Citation
  • 27

    de Jong M, Breeman WA, Valkema R et al.. Combination radionuclide therapy using 177Lu- and 90Y-labeled somatostatin analogs. J Nucl Med 2005;46(Suppl 1):13S17S.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 234 27 4
PDF Downloads 100 16 4
EPUB Downloads 0 0 0