Intra-arterial peptide receptor radionuclide therapy (IA-PRRT) in patients with SSTR-expressing neuroendocrine neoplasms: short- and long-term safety and efficacy for up to 13 years

作者：Jingjing Zhang, Birger Mensel, Richard P. Baum · 发表于：Theranostics · 年份：2025 · DOI：10.7150/thno.112012 · 被引用次数：2 · 研究领域：Neuroendocrine Tumor Research Advances、Radiopharmaceutical Chemistry and Applications、Thyroid Cancer Diagnosis and Treatment

Intravenous peptide receptor radionuclide therapy (IV-PRRT) has established its role in the treatment algorithm of somatostatin receptor (SSTR)-expressing neuroendocrine neoplasms (NENs).This study aims to evaluate the safety and efficacy of intra-arterial PRRT (IA-PRRT) in patients with SSTR-expressing NENs.Methods: The radiopharmaceutical was injected by a dedicated radionuclide infusion set via an intra-arterial catheter entering the femoral artery access site, with a microcatheter placed in the common hepatic artery or other selected artery via a standard access using the common femoral artery.Morphologic and molecular responses were evaluated in accordance with RECIST 1.1 and the EORTC criteria with 68 Ga-SSTR PET/CT.Kaplan-Meier survival analysis was performed to calculate median progression-free survival (PFS) and overall survival (OS).Short-and long-term toxicities were documented in accordance with the CTCAE, version 5.0.Results: 52 patients with SSTR-expressing NENs treated with intra-arterial PRRT with 177 Lu-or 90 Y-DOTATOC/DOTATATE from February 1999 to January 2019 were reviewed.The median follow-up time was 94.4 mo.Safety analysis demonstrated anemia (grade 1, n=4), leukocytopenia (grade 1, n=3; grade 2, n=1; grade 3, n=1), thrombocytopenia (grade 1, n=11) following IA-PRRT compared to baseline.No severe nephrotoxicity or liver dysfunction was observed after IA-PRRT.According to RECIST 1.1, the disease control rate at 3-6 mo after IA-PRRT was 89.4%, and the bes...