Title: Locoregional and radioisotopic targeted treatment of neuroendocrine tumours
Authors: Hendlisz, A ×
Flamen, P
Van den Eynde, M
Borbath, I
Demetter, P
Demolin, G
Pattyn, P
Pauwels, S
Peeters, M
Roeyen, G
Van Cutsem, Eric
Van Hootegem, Philippe
Van Laethem, J L
Verslype, Chris
Delaunoit, T #
Issue Date: Jan-2009
Publisher: Acta Medica Belgica
Series Title: Acta Gastro-Enterologica Belgica vol:72 issue:1 pages:44-48
Abstract: Gastro-entero-pancreatic neuroendocrine tumours (GEP NET) are a heterogeneous group of proliferative disorders whose management dramatically relies on tumour biology. For well-differentiated, low-proliferative index tumours, locoregional treatment and targeted radioisotopic therapies offer an attractive and seemingly efficient alternative to palliative surgical resections. Lack of well-designed, prospective, randomized multicentric studies hinders a balanced evaluation of available locoregional treatment methods: embolization, chemo-embolization, radio-embolization. According to available datas, all techniques achieve a 50-60% radiological response rate and almost 80% of symptomatic relieve for the patients, while their impact on progression-free and overall survival remains not assessable. Same conclusions can be drawn for radiolabeled targeted therapies like MetaiodoBenzylGuanidine (MIBG) and Peptide Receptor Radionuclide Therapy (PRRT), which, provided that their target is expressed by tumour cells, can deliver therapeutic doses of radiation to neoplastic tissues. 131I-MIBG has been associated with a 50% symptomatic response rate and mainly haematological toxicities. PRRT with 111In-DiethyleneTriamineentaacetic Acid-Octreotide, [90Y-DOTA0-Tyr3]-Octreotide, or [177Lu-DOTA0-Tyr3]-Octreotate seem to alleviate symptoms in 50% of patients and obtain a radiological response in 30-38%. Renal toxicity, partially preventable, is more frequent than previously thought and result in an annual decrease in glomerular function by 4 to 8% per year. Forthcoming research in GEP NET should by a majority be designed in randomized, prospective and multicentric fashion. Locoregional disease trials must focus on clinical outcome differences between embolization techniques (embolization, chemoembolization and radioembolization) and surgery. In disseminated disease, studies should assess radiolabeled targeted therapies efficiency when administered along with and compared to new biological and older chemotherapeutic agents.
ISSN: 0001-5644
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hepatology
Translational Research in GastroIntestinal Disorders
Clinical Digestive Oncology (+)
Faculty of Medicine - miscellaneous
× corresponding author
# (joint) last author

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