A review of the Scottish national Peptide Receptor Radionuclide Therapy (PRRT) service with focus on patients with small bowel neuroendocrine tumors (SBNET) treated between April 2019 and March 2021

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Introduction: Scottish National PRRT Service delivers 177Lu-Dotatate nationally at the Beatson West of Scotland Cancer Centre (BWoSCC). The NETTER-1 trial (Strosberg et al 2017) significantly changed the treatment and management of patients with gastroenteropancreatic NET (GEPNET). 177Lu-Dotatate demonstrated superiority in progression free survival (PFS) in patients with G1 and 2 midgut neuroendocrine tumors (NET). 177Lu-Dotatate 7.4 GBq 8 weekly gave 65% estimated progression free survival (PFS)at 20 months versus 10.8 % with 60mg octreotide intramuscularly 4 weekly (Strosberg et al 2017). Prior to this study everolimus was the most common 2nd line treatment for SBNET with a PFS of 14 months (Puscuddo et al 2017).

Aim(s): To compare overall response and PFS of patients being treated at the BWoSCC from 2019-21 with the primary analysis of the NETTER-1 trial at 20 months post randomisation.

Materials and methods: 49 patients with locally advanced or metastatic well-differentiated, somatostatin receptor positive SBNET with radiological progression receiving long acting somatostatin analogue treatment were identified. Forty patients completed 4 cycles of treatment (age 37-87). PFS was calculated from date of last treatment to radiological progression.

Conference:

Presenting Author:

Authors: Wotherspoon I, Charlick A, McIntosh D, Reed N,

Keywords: NETTER-1, Scottish PRRT Service,