Personalised dosimetry as a key for optimising radioligand therapy (RLT) with [177Lu]Lu-DOTA-TATE or [177Lu]Lu-DOTA-TATE and [90Y]Y-DOTA-TATE in patients with neuroendocrine tumors – The DUONEN multicenter study

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Introduction: To date, there is no clear consensus on the optimal RLT regimen. In theory, simultaneous use of two radionuclides with different energy and radiation ranges should be more effective than monotherapy. Individually tailored dosimetry may improve the results of RLT while maintaining its safety.

Aim(s): The main goal of the DUONEN study is to develop a personalized (dosimetry-based) RLT algorithm for patients with disseminated NET.

Materials and methods: Adult patients with advanced, unresectable well-differentiated (G1/G2) GEP-NETs, progressing on long-acting SSA are randomized into four arms: A-treated with [177Lu]Lu -DOTATATE with constant radioactivity of 7400MBq/per cycle | B-treated with a mixture of [177Lu]Lu-DOTATATE and [90Y]Y-DOTATATE initially in a ratio of 3700:1850MBq/MBq, than the [90Y]Y-DOTATATE dose is adjusted based on individual dosimetry to maintain the highest possible radiation dose in tumor tissue | C-analogous to arm B, but the dose of [90Y]Y-DOTATATE is constant and the dose of [177Lu]Lu-DOTATATE is adjusted based on the dosimetry | D-treated with [177Lu]Lu -DOTATATE initially with a dose of 7400MBq and then with doses based on individual dosimetry. In each case the individual dosimetry of kidney and bone marrow is performed.

Conference:

Presenting Author: Opalinska M

Authors: Opalinska M, Kaminski G, Dedecjus M, Kowalska A, Kolodziej M,

Keywords: PRRT, RLT, personalized RTL, NET, Dosimetry,