Endo Annual 2022

Predicting Toxicity of Peptide Receptor Radionuclide Therapy (PRRT) in Patients with Somatostatin Receptor-positive Metastatic Neuroendocrine Tumors Treated with 177Lu-dotatate

Shani Attia Konyo 5,6 Reut Halperin 1,6 Naama Halpern 4,6 Yossi Bar-On 2,6 Liran Domachevsky 3,6 Amit Tirosh 1,6
1ENTIRE Center and NET Service, Sheba Mc
2Surgery B, Sheba Mc
3Nuclear Medicien Institute, Sheba Mc
4Oncology Center, Sheba Mc
5Intgernal Medicine E, Sheba Mc
6Faculty of Medicine, Tel Aviv University

Introduction:
Peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE is considered the most efficacious intervention for patients with metastatic well-differentiated neuroendocrine tumors expressing somatostatin receptors. The aim of this study was to identify toxicity susceptibility markers, for hematologic, renal and hepatic toxicities.

Methods:
This was a retrospective cohort study. Data were obtained from Sheba Medical Center electronic database. Patients were treated with 177Lu-DOTATATE based on the NETTER-1 protocol and multidisciplinary team discussion. Serial blood tests were recorded for complete blood count, liver and kidney function tests before each PRRT cycle (baseline), 2-4 weeks post-cycle, and at last follow-up.

Results:
Twenty-four patients were included, 14 (58.3%) men. Three patients received chemotherapy before PRRT. Baseline leukocytes and platelets counts decreased over the four treatment PRRT cycles (Kruskal-Wallis, p

Conclusion:
177Lu-DOTATATE is associated with increased liver tissue vulnerability and kidney damage reflected by early hyperfiltration. 1st cycle changes may serve as markers for overall bone marrow and kidney toxicity.