NEUROENDOCRINE TUMORS
Guest Editors: Bombardieri E. 

The Quarterly Journal of Nuclear Medicine 2000 March;44(1):88-95

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

In situ radiotherapy with 111In-pentetreotide. State of the art and perspectives

McCarthy K. E., Woltering E. A. *, Anthony L. B. **

From the Department of Radiology Section of Nuclear Medicine *Department of Surgery Section of Endocrine Surgery **Department of Medicine Section of Hematology/Oncology Louisiana State University Health Sciences Center The LSUHSC Stanley S. Scott Cancer Center New Orleans, LA, USA

111In-pen­tet­re­o­tide (Octreoscan®) and oth­er radio­lab­eled som­a­tos­ta­tin ana­logs are use­ful in the man­age­ment of ­well dif­fer­en­tiat­ed neu­ro­en­do­crine malig­nan­cies ­such as car­ci­noid or ­islet ­cell neo­plasms. These radio­pep­tides ­bind to mem­brane ­bound som­a­tos­ta­tin recep­tors (sst 1-5) ­which are ­over-­expressed in a ­wide varie­ty of neo­plasms, espe­cial­ly ­those aris­ing ­from the neu­ro­ec­to­derm. Imaging advanc­es ­allow for the non­in­va­sive deter­mi­na­tion of the pres­ence of sst recep­tors by com­bin­ing radio­ac­tiv­ity [111Indium ­with a som­a­tos­ta­tin ana­log, ­DTPA-D-phe1-octre­o­tide (pen­tet­re­o­tide)]. Radiolabe-led som­a­tos­ta­tin ana­logs ­bind to mem­brane recep­tors and inter­nal­iza­tion of the com­plex ­occurs. Auger emit­ting som­a­tos­ta­tin ana­logs ­offer a nov­el and sig­nif­i­cant­ly ­less tox­ic ­approach to con­trol­ling neo­plas­tic dis­eas­es by deliv­er­ing tar­get­ed radi­a­tion spe­cif­i­cal­ly to recep­tor bear­ing ­cells ­while spar­ing recep­tor neg­a­tive ­cells. Responses of 62-69% in 85 ­patients ­with met­a­stat­ic neu­ro­en­do­crine ­tumors treat­ed ­with ­high ­dose (6-19.6 GBq) 111In-pen­tet­re­o­tide, spe­cif­i­cal­ly tar­get­ing ­tumor som­a­tos­ta­tin recep­tors, ­have ­been report­ed. Objective respons­es ­observed includ­ed bio­chem­i­cal and radio­graph­ic respons­es ­with pro­longed sur­vi­val. This arti­cle ­will dis­cuss and ­review the mul­ti-cen­ter ­data avail­able to ­date, the mech­a­nisms of ­action of radio­lab­eled som­a­tos­ta­tin ana­logs, dosim­e­try, clin­i­cal ­response param­e­ters, and tox­ic­ity.