Résultats et perspectives des traitements par Lutathera des tumeurs neuroendocrines à l’hôpital de Beaujon, centre RENATEN

Abstract

Peptide receptor radionuclide therapy of Lutathera became an important treatment for neuroendocrine tumor with metastases. Nuclear medecine department at Beaujon hospital could offered this therapy since 2013. We present therapies results between 2013 and 2018. Fifty-five patients had treated and included retrospectively. The procedure is usually 4 cures every 8 weeks with 7.4GBq by cure. We offered 3.5 GBq for patients who had high risk of hepatic or medullar adverses. We used RECIST 1.1 criteria to evaluate antitumoral response. Statistical evaluation included Kaplan-Meier and Log Rank test for progression free survival. At the end of treatment, there are 35 in stable, 12 in partial response and 8 in progression disease. The median free progression survival is 28 months. The median is 18 months for patient who received 3.5GBq, significatively inferior than who received 7.4GBq. Good responses are also obtained for patients who had fast evolutive disease (OMS Grade 3, hyperfixations lesions with PET-FDG). We offered neoadjuvant treatment before surgery for oligometastatic disease for one patient and she have always a complete response disease 1.5 years after surgery. 5 patients had 2 PRRT spacing 2.5 years with same response between the two Lutathera treatments. Then, hematologic tolerance is good, not exceeding OMS Grade 2. To conclude, this study confirms the importance of Lutathera for neuroendocrine tumor and opens possibilities to treat more patients.