Sequencing of somatostatin-receptor–based therapies in neuroendocrine tumor patients Review
| Authors: | Strosberg, J. R.; Al-Toubah, T.; El-Haddad, G.; Lagunes, D. R.; Bodei, L. |
| Review Title: | Sequencing of somatostatin-receptor–based therapies in neuroendocrine tumor patients |
| Abstract: | Most well-differentiated neuroendocrine tumors (NETs) express high levels of somatostatin receptors, particularly subtypes 2 and 5. Somatostatin analogs (SSAs) bind to somatostatin receptors and are used for palliation of hormonal syndromes and control of tumor growth. The long-acting SSAs octreotide long-acting release and lanreotide are commonly used in the first-line metastatic setting because of their tolerable side effect profile. Radiolabeled SSAs are used both for imaging and for treatment of NETs.177Lu-DOTATATE is a b-emitting radiolabeled SSA that has been proven to significantly improve progression-free survival among patients with progressive midgut NETs and is approved for treatment of metastatic gastroenteropancreatic NETs. A key question in management of patients with gastroenteropancreatic and lung NETs is the sequencing of177Lu-DOTATATE in relation to other systemic treatments (such as everolimus) or liver-directed therapies. This question is particularly complicated given the heterogeneity of NETs and the near absence of randomized trials comparing active treatment options. This state-of-the-art review examines the evidence supporting use of somatostatin-receptor–targeted treatments within the larger landscape of NET therapy and offers insights regarding optimal patient selection, assessment of benefit versus risk, and treatment sequencing. COPYRIGHT © 2024 by the Society of Nuclear Medicine and Molecular Imaging. |
| Keywords: | protein expression; gene sequence; cancer growth; drug efficacy; patient selection; risk benefit analysis; side effect; cancer staging; cancer grading; quality of life; evidence based practice; diagnostic imaging; risk assessment; neuroendocrine tumor; octreotide; neoplasms, second primary; angiopeptin; somatostatin; neuroendocrine tumors; neuroendocrine carcinoma; carcinoma, neuroendocrine; somatostatin receptor; molecularly targeted therapy; gastroenteropancreatic neuroendocrine tumor; somatostatin analogs; radionuclide therapy; radiolabeling; humans; human; article; receptors, somatostatin; lanreotide; prrt; oxodotreotide lutetium lu 177; pulmonary carcinoid; second primary neoplasm |
| Journal Title: | Journal of Nuclear Medicine |
| Volume: | 65 |
| Issue: | 3 |
| ISSN: | 0161-5505 |
| Publisher: | Society of Nuclear Medicine |
| Date Published: | 2024-03-01 |
| Start Page: | 340 |
| End Page: | 348 |
| Language: | English |
| DOI: | 10.2967/jnumed.123.265706 |
| PUBMED: | 38238038 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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