Abstract

BackgroundNeuroblastoma (NB) is one of the most frequently diagnosed tumors in infants. NB is a neuroendocrine tumor type with various characteristics and features, and with diverse outcome. The most malignant NBs have a 5-year survival rate of only 40–50%, indicating the need for novel and improved treatment options. 177Lu-octreotate is routinely administered for treatment of neuroendocrine tumors overexpressing somatostatin receptors (SSTR). The aim of this study was to examine the biodistribution of 177Lu-octreotate in mice bearing aggressive human NB cell lines, in order to evaluate the potential usefulness of 177Lu-octreotate for treatment of NB.MethodsBALB/c nude mice bearing CLB-BAR, CLB-GE or IMR-32 tumor xenografts (n = 5–7/group) were i.v. injected with 0.15 MBq, 1.5 MBq or 15 MBq 177Lu-octreotate and sacrificed 1 h, 24 h, 48 h and 168 h after administration. The radioactivity concentration was determined for collected tissue samples, tumor-to-normal-tissue activity concentration ratios (T/N) and mean absorbed dose for each tissue were calculated. Immunohistochemical (IHC) staining for SSTR1–5, and Ki67 were carried out for tumor xenografts from the three cell lines.ResultsHigh 177Lu concentration levels and T/N values were observed in all NB tumors, with the highest for CLB-GE tumor xenografts (72%IA/g 24 h p.i.; 1.5 MBq 177Lu-octreotate). The mean absorbed dose to the tumor was 6.8 Gy, 54 Gy and 29 Gy for CLB-BAR, CLB-GE and IMR-32, respectively, p.i. of 15 MBq 177Lu-octreotate. Receptor saturation was clearly observed in CLB-BAR, resulting in higher concentration levels in the tumor when lower activity levels where administered. IHC staining demonstrated highest expression of SSTR2 in CLB-GE, followed by CLB-BAR and IMR-32.ConclusionT/N values for all three human NB tumor xenograft types investigated were high relative to previously investigated neuroendocrine tumor types. The results indicate a clear potential of 177Lu-octreotate as a therapeutic alternative for metastatic NB.

Highlights

  • Neuroblastoma (NB) represents 7–9% of all tumors detected in children [1, 2]

  • Patients with NB are divided into different riskassessment groups, and The International Neuroblastoma Risk Group (INRG) applies a classification system based on key NB criteria, such as age, stage, tumor histology, MYCN amplification (MNA), 11q deletion and ploidy to define very low, low, intermediate, and highrisk (HR) groups according to 5-year event-free survival (EFS) [4]

  • Tumor tissue High 177Lu activity concentration levels were observed in CLB-BAR, CLB-GE and IMR-32 NB xenograft tumors (Tables 1, 2 and 3, Figs. 1, 2 and 3), with the highest value (59%IA/g 1 h p.i.) observed in mice bearing CLBBAR xenografts after administration of 0.15 MBq 177Luoctreotate

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Summary

Introduction

Neuroblastoma (NB) represents 7–9% of all tumors detected in children [1, 2]. NB are neuroendocrine tumors (NETs), deriving from primitive nerve cells in the sympathetic nervous system. Patients with NB are divided into different riskassessment groups, and The International Neuroblastoma Risk Group (INRG) applies a classification system based on key NB criteria, such as age, stage, tumor histology, MYCN amplification (MNA), 11q deletion and ploidy to define very low-, low-, intermediate-, and highrisk (HR) groups according to 5-year event-free survival (EFS) [4]. Patients with HR-NB have a 5-year survival rate of only 40–50%, as compared to 90–100% for those with low-risk NB [5, 6]. Surgery alone leads to a good prognosis for patients with resectable low-risk NB. NB is a neuroendocrine tumor type with various characteristics and features, and with diverse outcome. The most malignant NBs have a 5-year survival rate of only 40–50%, indicating the need for novel and improved treatment options. The aim of this study was to examine the biodistribution of 177Lu-octreotate in mice bearing aggressive human NB cell lines, in order to evaluate the potential usefulness of 177Lu-octreotate for treatment of NB

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