213 Bi and Ac 225 DOTATOC Receptor Labeled Targeted Alpha-Radionuclide Therapy in Neuroendocrine Tumors Refractory to Beta Radiation - Early Experience

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Introduction: Radiopeptide therapy using a somatostatin analogue labeled with alpha emitters Actinium 225 and Bismuth 213 DOTATOC is a novel therapeutic option in metastatic neuroendocrine tumors (NET), with few alternative therapeutic options for patients with beta refractory disease. We report the first experience with 213Bi and Ac225 DOTATOC targeted alpha therapy (TAT) in treatment of well differentiated metastatic NETs at a tertiary care hospital in India.

Aim(s): To assess safety and efficacy of alpha emitter labeled somatostatin analogue therapy in well differentiated NETs To evaluate radiological response and its correlation with clinical parameters.

Materials and methods: Ten patients with progressive metastatic neuroendocrine tumors, refractory to 177Lu-DOTATATE therapy were treated with 1-2 cycles (average 1.2) of 213Bi or Ac225 labeled DOTATOC, with two patient receiving intraarterial infusion of 213Bi-DOTATOC for extensive liver disease. Haematological, hepatic, renal and endocrine toxicities were assessed according to CTCAE criteria. Radiological response was assessed on 68Ga-DOTANOC-PET imaging 8 weeks post therapy.

Conference: 15th Annual ENETSConcerence (2018)

Presenting Author: Dureja S

Authors: Dureja S, Sen I, Pant V, Thak P,

Keywords: Targeted alpha therapy, TAT, PRRT, neuroendocrine tumors, beta refractory,