Radionuclide Theranostics in Neuroendocrine Neoplasms: An Update

IF 4.7 2区医学 Q1 ONCOLOGY Current Oncology Reports Pub Date : 2024-04-06 DOI:10.1007/s11912-024-01526-5

Martina Di Franco, Lucia Zanoni, Emilia Fortunati, Stefano Fanti, Valentina Ambrosini

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Abstract

Purpose of Review

This paper aims to address the latest findings in neuroendocrine tumor (NET) theranostics, focusing on new evidence and future directions of combined diagnosis with positron emission tomography (PET) and treatment with peptide receptor radionuclide therapy (PRRT).

Recent Findings

Following NETTER-1 trial, PRRT with [177Lu]Lu-DOTATATE was approved by FDA and EMA and is routinely employed in advanced G1 and G2 SST (somatostatin receptor)-expressing NET. Different approaches have been proposed so far to improve the PRRT therapeutic index, encompassing re-treatment protocols, combinations with other therapies and novel indications. Molecular imaging holds a potential added value in characterizing disease biology and heterogeneity using different radiopharmaceuticals (e.g., SST and FDG) and may provide predictive and prognostic parameters. Response assessment criteria are still an unmet need and new theranostic pairs showed preliminary encouraging results.

Summary

PRRT for NET has become a paradigm of modern theranostics. PRRT holds a favorable toxicity profile, and it is associated with a prolonged time to progression, reduction of symptoms, and improved patients’ quality of life. In light of further optimization, different new strategies have been investigated, along with the development of new radiopharmaceuticals.

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神经内分泌肿瘤的放射性核素放射治疗：最新进展

综述目的本文旨在探讨神经内分泌肿瘤（NET）治疗学的最新研究成果，重点关注正电子发射断层扫描（PET）联合诊断和肽受体放射性核素疗法（PRRT）联合治疗的新证据和未来发展方向。最新研究成果继NETTER-1试验之后，[177Lu]Lu-DOTATATE PRRT获得了FDA和EMA的批准，并被常规用于晚期G1和G2 SST（体生长激素受体）表达NET的治疗。迄今为止，已经提出了不同的方法来提高 PRRT 的治疗指数，包括再治疗方案、与其他疗法的组合以及新的适应症。分子成像在利用不同放射性药物（如 SST 和 FDG）描述疾病生物学特性和异质性方面具有潜在的附加值，并可提供预测和预后参数。反应评估标准仍是一项尚未满足的需求，而新的治疗药物对显示出初步的令人鼓舞的结果。PRRT具有良好的毒性，可延长疾病进展时间，减轻症状，改善患者生活质量。为了进一步优化，人们研究了不同的新策略，并开发了新的放射性药物。

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来源期刊

Current Oncology Reports ONCOLOGY-

CiteScore

8.50

自引率

0.00%

发文量

187

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.