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Efficacy of 177Lu Peptide Receptor Radionuclide Therapy for the Treatment of Neuroendocrine Tumors

A Meta-analysis

Saravana-Bawan, Bianka MD*; Bajwa, Amandeep MD*; Paterson, John MD; McEwan, Alexander J. B. MD; McMullen, Todd P. W. MD, PhD*

doi: 10.1097/RLU.0000000000002646
Original Articles
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Objective The purpose of this study was to assess the efficacy of 177Lu-labeled peptide receptor radionuclide therapy (PRRT) induction treatments for patients with unresectable metastatic neuroendocrine tumors.

Methods MEDLINE, EMBASE, and Ovid were systematically searched with keywords “lutetium,” “Lu-177,” “PRRT,” “neuroendocrine,” and “prognosis.” Studies evaluating treatment with 177Lu-labeled PRRT were assessed for disease response and/or disease control rate by Response Evaluation Criteria in Solid Tumors (RECIST) 1.0 or 1.1, modified RECIST, Southwest Oncology Group (SWOG), or modified SWOG criteria. Pooled proportions of disease response and control rates were calculated for both fixed- and random-effects models.

Results Eighteen studies with 1920 patients were included (11 with 1268 patients using RECIST and 6 with 804 patients using SWOG). By RECIST criteria, the pooled disease response rate by random-effects model was 29.1% (95% confidence interval [CI], 20.2%–38.9%), and disease control rate was 74.1% (95% CI, 67.8%–80.0%). By SWOG criteria, the pooled disease response rate by random-effects model was 30.6% (95% CI, 20.7%–41.5%), and disease control rate was 81.1% (95% CI, 76.4%–85.4%).

Conclusions Induction therapy, typically 4 treatments, with 177Lu PRRT is an effective method of treating unresectable metastatic neuroendocrine tumors with significant disease response and control rates.

From the Departments of *Surgery

Family Medicine

Oncology, University of Alberta, Edmonton, Alberta, Canada.

Received for publication March 19, 2019; revision accepted April 11, 2019.

Conflicts of interest and sources of funding: T.P.W.M. is a paid consultant with Galapagos LLC and has received speaker fees from Novartis. The authors otherwise have none declared.

Correspondence to: Todd P. W. McMullen, MD, PhD, Department of Surgery, University of Alberta Hospital, 8440-112 St NW, 2D4.41 Walter C. Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada T6G 2B7. E-mail: todd.mcmullen@ahs.ca.

Online date: June 14, 2019

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