Outcome on Mesenteric Mass Response of Small-Intestinal Neuroendocrine Tumors Treated by 177 Lu-DOTATATE Peptide Receptor Radionuclide Therapy: The MesenLuth Study, a National Study from the French Group of Endocrine Tumors and Endocan-RENATEN Network - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Journal of Nuclear Medicine Année : 2024

Outcome on Mesenteric Mass Response of Small-Intestinal Neuroendocrine Tumors Treated by 177 Lu-DOTATATE Peptide Receptor Radionuclide Therapy: The MesenLuth Study, a National Study from the French Group of Endocrine Tumors and Endocan-RENATEN Network

Laure Al Mansour
  • Fonction : Auteur
Louis de Mestier
  • Fonction : Auteur
Magalie Haissaguerre
  • Fonction : Auteur
Pauline Afchain
  • Fonction : Auteur
Julien Hadoux
  • Fonction : Auteur
Thierry Lecomte
  • Fonction : Auteur
David Morland
  • Fonction : Auteur
Anne Segolene Cottereau
  • Fonction : Auteur
Ophelie de Rycke
  • Fonction : Auteur
Ghoufrane Tlili
  • Fonction : Auteur
Jérémie Tordo
  • Fonction : Auteur
Marc Janier
  • Fonction : Auteur
Agathe Deville
  • Fonction : Auteur

Résumé

A mesenteric mass (MM), characterized by fibrotic reaction, is present in most small-intestinal neuroendocrine tumors (SI-NETs). 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) has shown its efficacy in patients with progressive SI-NETs. However, because of specific tissue characteristics of desmoplastic MMs, we hypothesize that these lesions may be refractory to 177Lu-DOTATATE PRRT. Methods: From the national French Groupe d'étude des Tumeurs Endocrines database, we identified patients with an advanced SI-NET and a MM (≥2 cm with a retractile aspect) of a SI-NET treated by at least 1 course of 177Lu-DOTATATE PRRT. The primary endpoint was a MM objective response rate (ORR) of less than 5%. Secondary endpoints were metabolic response, MM-related safety, and clinical response, as well as MM progression-free survival (PFS) and non-MM PFS. Results: In total, 52 patients were included. The MM ORR was 4% (n = 2), and the non-MM ORR was 8% (n = 4). No patient had a MM metabolic response, and the non-MM metabolic response rate was 12% (n = 6). Among the 26 patients with baseline MM-related symptoms, 46% had a clinical response. Four patients presented with gastrointestinal complications during PRRT. The median MM-related PFS was not reached, and the non-MM PFS was 50.3 mo (95% CI, 38.2-61.7 mo). Conclusion: This study confirms that 177Lu-DOTATATE PRRT does not lead to morphologic response on MMs (ORR < 5%). However, it allows MM stability, with few MM-related side effects, and has a relevant impact on MM-related symptoms.

Dates et versions

hal-04465202 , version 1 (19-02-2024)

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Paternité - Pas d'utilisation commerciale - Pas de modification

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Citer

Laure Al Mansour, Louis de Mestier, Magalie Haissaguerre, Pauline Afchain, Julien Hadoux, et al.. Outcome on Mesenteric Mass Response of Small-Intestinal Neuroendocrine Tumors Treated by 177 Lu-DOTATATE Peptide Receptor Radionuclide Therapy: The MesenLuth Study, a National Study from the French Group of Endocrine Tumors and Endocan-RENATEN Network. Journal of Nuclear Medicine, 2024, 65 (2), pp.258-263. ⟨10.2967/jnumed.123.266063⟩. ⟨hal-04465202⟩
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