Case Report: Re-Treatment With Lu-DOTATATE in Neuroendocrine Tumors

• Main Authors: Elena María Vida Navas, Alberto Martínez Lorca, Aintzane Sancho Gutiérrez, Lucia Sanz Gómez, Teresa Navarro Martínez, Enrique Grande Pulido, Alfredo Carrato Mena, Pablo Gajate Borau
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2021-04-01
• Series: Frontiers in Endocrinology
• Subjects: neuroendocrine tumors; Lu-DOTATATE; neuroendocrine neoplasms; peptide receptor radionuclide therapy; case report
• Online Access: https://www.frontiersin.org/articles/10.3389/fendo.2021.676973/full

Peptide receptor radionuclide therapy (PRRT) is an established treatment in advanced neuroendocrine tumors (NETs), which overexpressed somatostatin receptors. However, after progression there are a limited number of available treatments. We want to share a case report about a patient with a NET re-treated with 177Lu-DOTATATE and a literature review about salvage treatment with PRRT. We present a 26-year-old man who started with pelvic pain and after a biopsy of a retro-rectal mass observed in a magnetic resonance was diagnosed with an advanced neuroendocrine tumour. After progression to lanreotide, everolimus and sunitinib, treatment with 177Lu-DOTATATE was initiated, achieving an excellent response with a progression free survival (PFS) of 38 months. At the time of progression, re-treatment with 177Lu-DOTATATE was decided, showing a new partial response, which is currently stable after 15 months. The patient had not presented significant treatment-related toxicity. Although there are no randomized phase III trials or a consensus about the number or dose of cycles, there is evidence about the efficacy and low toxicity of salvage treatment with 177Lu-DOTATATE in NETs. Median progression-free survival ranges from 6 to 22 months. Toxicity is mostly hematologic (anemia and neutropenia), 4-7% grade 3/4.