Intra-arterial PRRT – A prospective clinical study in NET patients with hepatic metastases

#3798

Introduction: Liver metastases of neuro-endocrine tumors have a significant impact on survival of patients treated with 177Lu-DOTATATE.

Aim(s): To investigate whether tumor uptake in liver metastases can be enhanced by intra-arterial (IA) administration of 177Lu-DOTATATE (Lutathera®, AAA) via the hepatic artery, in order to improve tumor response without increasing toxicity.

Materials and methods: In this prospective RCT, a total of 26 patients with grade 1-2 NET and bi-lobar liver metastases were randomized to receive IA PRRT in either the left or right hepatic artery for four treatment cycles. The other liver lobe was treated via a 'second-pass' effect (i.e. the control lobe). Up to 3 tumors per liver lobe were identified as target lesions at baseline (>3 cm). Tumor-to-normal (T/N) uptake ratios on 24h post-treatment SPECT/CT were calculated for each target lesion using the mean uptake and peak uptake (mean uptake in 1cm diameter sphere around maximum uptake voxel) and compared between IA-treated lobe (IAL) and control lobe (CL) using paired-samples t-test. Furthermore, per-tumor and per-patient response was recorded according to RECIST 1.1 at 3- and 6-months post-treatment.

Conference:

Presenting Author:

Authors: Ebbers S, Barentsz M, de Vries-Huizing D, Versleijen M, Klompenhouwer L,

Keywords: PRRT, intra-arterial, lutetium, neuroendocrine tumor, peptide receptor radionuclide therapy, treatment response,