90Y-Edotreotide for Metastatic Carcinoid Refractory to Octreotide
- 1 April 2010
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 28 (10), 1652-1659
- https://doi.org/10.1200/jco.2009.22.8585
Abstract
Purpose: Metastatic carcinoid is an incurable malignancy whose symptoms, such as diarrhea and flushing, can be debilitating and occasionally life-threatening. Although symptom relief is available with octreotide, the disease eventually becomes refractory to octreotide, leaving no proven treatment options. The goal of this study was to evaluate the clinical effect of using 90Y-edotreotide to treat symptomatic patients with carcinoid tumors. Patients and Methods: Patients enrolled had metastatic carcinoid, at least one sign/symptom refractory to octreotide, and at least one measurable lesion. Study treatment consisted of three cycles of 4.4 GBq (120 mCi) 90Y-edotreotide each, once every 6 weeks. Results: Ninety patients were enrolled in the study. Using Southwest Oncology Group tumor response criteria, 67 (74.%) of 90 patients (95% CI, 65.4% to 83.4%) were objectively stable or responded. A statistically significant linear trend toward improvement was demonstrated across all 12 symptoms assessed. Median progression-free survival was significantly greater (P = .03) for the 38 patients who had durable diarrhea improvement than the 18 patients who did not (18.2 v 7.9 months, respectively). Adverse events (AEs) were reported in 96.7% (87 of 90) of patients. These AEs consisted primarily of reversible GI events (76 of 90), which could be caused in part by concomitant administration of amino acid solution given to reduce radiation exposure to the kidneys. There was one case each of grade 3 oliguria and grade 4 renal failure, each lasting 6 days. Conclusion: 90Y-edotreotide treatment improved symptoms associated with malignant carcinoid among subjects with no treatment alternatives. Treatment was well-tolerated and had an acceptable expected AE profile.Keywords
This publication has 31 references indexed in Scilit:
- Survival and Response After Peptide Receptor Radionuclide Therapy With [90Y-DOTA0,Tyr3]Octreotide in Patients With Advanced Gastroenteropancreatic Neuroendocrine TumorsSeminars in Nuclear Medicine, 2006
- Phase II/III Study of Doxorubicin With Fluorouracil Compared With Streptozocin With Fluorouracil or Dacarbazine in the Treatment of Advanced Carcinoid Tumors: Eastern Cooperative Oncology Group Study E1281Journal of Clinical Oncology, 2005
- Effects of Intravenous Amino Acid Administration with Y-90 DOTA-Phe1-Tyr3-Octreotide (SMT487[OctreoTher™]) TreatmentCancer Biotherapy & Radiopharmaceuticals, 2004
- Rapid and Sustained Relief from the Symptoms of Carcinoid Syndrome: Results from an Open 6-Month Study of the 28-Day Prolonged-Release Formulation of LanreotideNeuroendocrinology, 2004
- Malignant carcinoids in the USA, SEER 1992–1999. An epidemiological study with 6830 casesEuropean Journal of Cancer Prevention, 2003
- A 5‐decade analysis of 13,715 carcinoid tumorsCancer, 2003
- Somatostatin analogue octreotide and inhibition of tumour growth in metastatic endocrine gastroenteropancreatic tumours.Gut, 1996
- ENDOCRINE TUMORS OF THE GASTROINTESTINAL TRACTAnnual Review of Medicine, 1996
- RESISTANCE OF METASTATIC PANCREATIC ENDOCRINE TUMOURS AFTER LONG‐TERM TREATMENT WITH THE SOMATOSTATIN ANALOGUE OCTREOTIDE (SMS 201–995)Clinical Endocrinology, 1989
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958