Influence of pretreatment with everolimus or sunitinib on the subacute hematotoxicity of <superscript>177</superscript>Lu-DOTATATE PRRT.
In: Acta Oncologica, Jg. 59 (2020-06-01), Heft 6, S. 644-651
academicJournal
Zugriff:
Background: Peptide receptor radionuclide therapy (PRRT) is a validated treatment for somatostatin receptor overexpressing neuroendocrine tumors (NETs). The NETTER-1 trial demonstrated a pronounced positive effect on progression-free-survival compared to high dose somatostatin analogs (SSAs), with a strong tendency toward overall survival benefit. Our aim was to investigate the influence of pretreatment with everolimus and/or sunitinib on subacute hematotoxicity of PRRT. To assess the influence of prior treatment with everolimus/sunitinib might be of clinical relevance due to the link between short-term hematotoxicity and increased incidence of late hematotoxicity. Material and methods: Our single-center retrospective study enrolled all patients treated with 177 Lu-DOTATATE PRRT (1–4 cycles of 7.4 GBq), between November 2013 and July 2018. Patients were assigned to two groups according to their pretreatment: no targeted agents (N = 41), or targeted agents (everolimus, sunitinib or both; N = 41). The end point was subacute hematotoxicity, defined as the nadir value between the first administration until 3 months after the last administration, using the CTCAE 4.03 classification. The impact of splenectomy was also explored. Results: Eighty percent of patients had a primary gastroenteropancreatic NET. No statistically significant differences in severe subacute hematotoxicity were seen in the pretreated group vs. the naive group for hemoglobin (grade 3/4: 12% vs. 22%), neither for leucocytes (grade 3/4: 10% vs. 7%), neutrophils (grade 3/4: 5% vs. 7%), lymphocytes (grade 3/4: 49% vs. 37%) and platelets (grade 3/4: 15% vs. 15%). Furthermore, we observed significantly lower toxicity for total white blood cells, lymphocytes and platelets in the subgroup that had splenectomy (N = 12). Limitations of this study include the potential bias in lack of use of targeted agents in patients more susceptible to toxicity, and the limited number of patients and events. Conclusions: In a patient cohort with NET pretreated with everolimus and/or sunitinib, we could not demonstrate a significant effect of prior/pretreatment with everolimus and/or sunitinib on the subacute hematotoxicity of 177 Lu-DOTATATE PRRT. [ABSTRACT FROM AUTHOR]
Copyright of Acta Oncologica is the property of Medical Journals Sweden AB and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Influence of pretreatment with everolimus or sunitinib on the subacute hematotoxicity of <superscript>177</superscript>Lu-DOTATATE PRRT.
|
---|---|
Autor/in / Beteiligte Person: | Medaer, Eva ; Verslype, Chris ; Van Cutsem, Eric ; Dekervel, Jeroen ; Clement, Paul M. ; Nackaerts, Kristiaan ; Laenen, Annouschka ; Gheysens, Olivier ; Goffin, Karolien ; Jentjens, Sander ; Van Laere, Koen ; Deroose, Christophe M. |
Zeitschrift: | Acta Oncologica, Jg. 59 (2020-06-01), Heft 6, S. 644-651 |
Veröffentlichung: | 2020 |
Medientyp: | academicJournal |
ISSN: | 0284-186X (print) |
DOI: | 10.1080/0284186X.2020.1723161 |
Schlagwort: |
|
Sonstiges: |
|