Steroid dosing to prevent tumour flare reaction with 177Lu-DOTATATE

#4572

Introduction: Tumour flare reactions including increased pain and small bowel obstruction (SBO) have been reported in patients with somatostatin receptor (SSTR)-positive gastroenteropancreatic neuroendocrine tumours (GEP-NETs) receiving 177Lu-DOTATATE. Retrospective reviews report tumour flare reactions in 6 to 40 percent of high-risk patients receiving 177Lu-DOTATATE and report success with using corticosteroid prophylaxis to prevent tumour flare recurrence with subsequent doses of 177Lu-DOTATATE (Strosberg, et al., 2021; Salner, et al., 2020).

Aim(s): Corticosteroid prophylaxis can be considered for patients with a high burden of disease or who have previously experienced a tumour flare reaction from 177Lu-DOTATATE. We hope to characterise the clinical utility of two different corticosteroid dosing regimens used at our institution to prevent tumour flare reactions in patients receiving 177Lu-DOTATATE.

Materials and methods: We identified adult patients with NETs who were treated with 177Lu-DOTATATE who received corticosteroids as prophylaxis for a flare reaction under IRB approval at Vanderbilt-Ingram Cancer Center. Variables were collected within a RedCAP database.

Conference:

Presenting Author:

Authors: Cass A, Skotte E, Wheless M, Stockton S, Ramirez R,

Keywords: 177Lu-DOTATATE, corticosteroid prophylaxis, tumour flare,