Lutetium-177 DOTATATE PRRT versus PRRT plus chemotherapy in metastatic well differentiated FDG-avid GEP-NETs – Results from a prospective cohort

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Introduction: Combination therapy with PRRT and Capecitabine-Temozolomide (CAPE-TMZ) has benefited patients with FDG avid well-differentiated GEP-NETs.

Aim(s): Combination strategy is based on retrospective studies, hence our study aimed at analysing a prospective cohort to assess progression-free (PFS) and overall survival (OS).

Materials and methods: 63 patients of GEP NETs showing DOTA (Krenning's 3/4) and FDG uptake (more than or equal to liver) were prospectively enrolled. 33 patients received PRRT and 30 patients received CAPE-TEM with PRRT. Patients received 4 cycles of PRRT, 8-12 weeks apart, during which chemotherapy was given. Patients of WHO Grade 1 and Grade 2 (Mib-1<5%) with clinic-radiological progression; and Grade 2 (Mib-1 index greater than 5%) and grade 3 were included. Kaplan Meier method was used for survival analysis and log rank t test to compare both groups. Subgroup analysis was performed for pancreatic and non-pancreatic NETs.

Conference:

Presenting Author:

Authors: Puranik A, Rangarajan V, Shrikhande S, Ramaswamy A, Ostwal V,

Keywords: PRRT, capecitabine, temozolomide, FDG PET, DOTA PET,