Findings of a retrospective analysis in patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) indicate that peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE may provide clinical benefit and does not significantly impair health-related quality of life (HRQoL).
A retrospective analysis sought to determine the HRQoL and survival outcomes of patients with metastatic GEP-NETs who received PRRT with 177Lu-DOTATATE; the results of this analysis were reported at the 2020 American Society of Clinical Oncology Virtual Scientific Program.
A total of 41 patients with GEP-NETs who received a mean of 3 cycles of 177Lu-DOTATATE between 2012 and 2017 at University Hospital Zurich were included in the study. HRQoL parameters of fatigue, insomnia, loss of appetite, abdominal pain, nausea, emesis, diarrhea, and weight loss were assessed before and after treatment. At least 3 weeks after the last PRRT cycle, data on blood parameters, HRQoL, and overall survival were extracted from patient records. Factors influencing the success of PRRT therapy and survival including pre- and post-PRRT treatments (eg, selective internal radiation therapy [SIRT], somatostatin analog [SSA] therapy, tyrosine kinase inhibitor, or chemotherapy) were assessed.
Overall, the majority of patients did not report any significant deterioration in HRQoL after PRRT treatment. PRRT also did not significantly impair blood parameters, including hemoglobin, leukocyte and platelet counts, creatinine, and glomerular filtration rate. The number of prior therapies received or the time period between first diagnosis and PRRT did not influence survival after PRRT. However, prior SIRT increased the mortality risk versus no prior SIRT (78% vs 46%; odds ratio [OR], 4.083), particularly when applied to patients with pancreatic tumors (mortality OR, 1.33). Also, SSA use after PRRT increased the odds of survival, with a mortality OR of 2.33 for patients without SSA use after PRRT (40% vs 61%).
These data indicate that PRRT with 177Lu-DOTATATE may provide clinical benefit to patients with advanced GEP-NETs and does not significantly impair the HRQoL. In terms of treatment sequence, no SIRT before PRRT and SSA use after PRRT increased survival in this patient population.
Source: Siebenhuener AR, et al. J Clin Oncol. 2020;38(15_suppl). Abstract 4606.
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