Effectiveness, safety, and retreatment outcomes in GEP-NET patients undergoing 177Lu-based PRRT: a ten-year real-world experience

作者：Leonhard Trinkl, Paul Thöne, Josef Dierneder, Holger Rumpold · 发表于：BMC Cancer · 年份：2026 · DOI：10.1186/s12885-026-16556-4 · 研究领域：Neuroendocrine Tumor Research Advances、Lung Cancer Research Studies、Radiopharmaceutical Chemistry and Applications

Peptide receptor radionuclide therapy (PRRT) using 177 Lu-labeled somatostatin analogues is an established and increasingly applied treatment for advanced gastroenteropancreatic neuroendocrine tumors (GEP-NETs). We report results focusing on effectiveness, short-term safety, and retreatment outcomes, based on ten years of clinical experience from an Austrian center of expertise, including patients referred for retreatment after prior therapy elsewhere. This retrospective study included 49 patients treated with 177 Lu-DOTATATE or 177 Lu-DOTATOC between 2014 and 2023. Subgroups included patients receiving their first PRRT course at our center (n = 45). Of this initial-treatment cohort, 9 patients subsequently underwent PRRT retreatment at our center. Additionally, 4 external patients previously treated with 90 Y-PRRT at another institution were referred for 177 Lu-based retreatment, resulting in a total retreatment subgroup of 13 patients. Overall survival (OS), progression-free survival (PFS), and selected laboratory toxicity parameters were evaluated according to CTCAE v5.0. In the GEP-NET group, the median number of PRRT cycles was 4 with a median cumulative activity of 27.9 GBq. Median OS was 54.2 months (95% CI: 33.2–upper bound not reached), and median PFS was 24.1 months (95% CI: 11.8–36.1). PET-CT-based response assessment was available in 36 of 45 patients. Using evaluable patients as denominator, the exploratory visual SSTR-PET-CT-based objective response rate was 30....