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Nancy Sharma, Boris G Naraev, Eric G Engelman, M Bridget Zimmerman, David L Bushnell, Thomas M OʼDorisio, M Sue OʼDorisio, Yusuf Menda, Jan Müller-Brand, James R Howe, Thorvardur R Halfdanarson
OBJECTIVES: The objective of this study was to describe the outcomes of patients in the University of Iowa Neuroendocrine Tumor (NET) Database treated with peptide receptor radionuclide therapy (PRRT). METHODS: One hundred thirty-five patients from the University of Iowa NET Database who received PRRT were analyzed, their characteristics were described, and survival was calculated. RESULTS: The median age at diagnosis was 51 years, and 64% were men...
October 18, 2016: Pancreas
Anna Yordanova, Karin Mayer, Markus Essler, Hojjat Ahmadzadehfar
Renal neuroendocrine tumor (NET) is an extremely rarely occurring disease. The sporadic reports in the literature are mostly case reports, or less commonly small studies. In cases of metastatic disease from renal NET, there are no established therapies. We are reporting our experience with a patient with extensive osseous infiltration of a renal NET, who was successfully treated with peptide receptor radionuclide therapy (PRRT) using Lu-DOTATATE. In a period of 10 years, the patient underwent in total 12 cycles of PRRT with a cumulative dose of 81 GBq...
October 5, 2016: Clinical Nuclear Medicine
Christoph Wetz, I Apostolova, I G Steffen, F Hofheinz, C Furth, D Kupitz, J Ruf, M Venerito, S Klose, Holger Amthauer
PURPOSE: The purpose of this study was to assess the value of the spatial heterogeneity of somatostatin receptor (SSR) volume, quantified as asphericity (ASP), and to predict response to peptide receptor radionuclide therapy (PRRT) in patients with metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). PROCEDURES: From June 2011 to May 2013, patients suffering from GEP-NEN who underwent pretherapeutic [(111)In-DTPA(0)]octreotide scintigraphy (Octreoscan®) prior to [(177)Lu-DOTA(0)-Tyr(3)]octreotate ([(177)Lu]DOTATATE)-PRRT were enrolled in this retrospective evaluation...
October 14, 2016: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Stefano M Priola, Felice Esposito, Salvatore Cannavò, Alfredo Conti, Rosaria V Abbritti, Valeria Barresi, Sergio Baldari, Francesco Ferraù, Antonino Germanò, Francesco Tomasello, Filippo F Angileri
BACKGROUND: Although pituitary adenomas are considered benign lesions, a small group may exhibit a clinically aggressive behavior, sometimes independently from the classic markers of aggressiveness, including the Ki67 labeling index and/or p53 expression. METHODS: We selected 7 subjects harboring a pituitary tumor with clinical features of aggressiveness. Patients underwent a full preoperative and postoperative endocrinological and neuroradiological work-up. Two were non-functioning, two PRL-secreting, two ACTH-secreting, and one a GH-secreting adenoma...
October 3, 2016: World Neurosurgery
Rudolf A Werner, Constantin Lapa, Harun Ilhan, Takahiro Higuchi, Andreas K Buck, Sebastian Lehner, Peter Bartenstein, Frank Bengel, Imke Schatka, Dirk O Muegge, László Papp, Norbert Zsótér, Tobias Große-Ophoff, Markus Essler, Ralph A Bundschuh
The NETTER-1 trial demonstrated significantly improved progression-free survival (PFS) for peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NET) emphasizing the high demand for response prediction in appropriate candidates. In this multicenter study, we aimed to elucidate the prognostic value of tumor heterogeneity as assessed by somatostatin receptor (SSTR)-PET/CT. 141 patients with SSTR-expressing tumors were analyzed obtaining SSTR-PET/CT before PRRT (1-6 cycles, 177Lu somatostatin analog)...
October 2, 2016: Oncotarget
Maddalena Sansovini, Stefano Severi, Annarita Ianniello, Silvia Nicolini, Lorenzo Fantini, Emilio Mezzenga, Fabio Ferroni, Emanuela Scarpi, Manuela Monti, Alberto Bongiovanni, Sara Cingarlini, Chiara Maria Grana, Lisa Bodei, Giovanni Paganelli
PURPOSE: Lu-DOTATATE (Lu-PRRT) is a valid therapeutic option in differentiated pancreatic neuroendocrine tumors (P-NETs). FDG PET seems to be an important prognostic factor in P-NETs. We evaluated the efficacy of Lu-PRRT and the role of FDG PET in 60 patients with advanced P-NETs. METHODS: From March 2008 to June 2011, 60 consecutive patients with P-NETs were enrolled in the study. Follow-up lasted until March 2016. Eligible patients were treated with two different total cumulative activities (18...
October 4, 2016: European Journal of Nuclear Medicine and Molecular Imaging
Grace Kong, Jason Callahan, Michael S Hofman, David A Pattison, Tim Akhurst, Michael Michael, Peter Eu, Rodney J Hicks
PURPOSE: Bulky disease is an adverse prognostic factor for (177)Lu-DOTA-octreotate ((177)Lu-DOTATATE) peptide receptor radionuclide therapy (PRRT). (90)Y-DOTA-octreotate ((90)Y-DOTATATE) has theoretical advantages in this setting but may less effectively treat co-existent smaller deposits and have higher toxicity than (177)Lu-DOTATATE. The aim of this study was to assess the efficacy and safety of using these agents sequentially. METHODS: We reviewed patients (pts) with at least one lesion of a transaxial diameter >4 cm who completed 1-2 cycles of (90)Y-DOTATATE followed by 2-3 cycles of (177)Lu-DOTATATE, with treatment empirically adapted to disease size and burden in individual patients...
September 27, 2016: European Journal of Nuclear Medicine and Molecular Imaging
Salvatore Berenato, Ernesto Amato, Alexander Fischer, Sergio Baldari
Internal dosimetry is a fundamental instrument for the personalization of nuclear medicine therapies, to maximize the therapeutic effect while minimizing the radiation burden to other organs. Three-dimensional (3D) dosimetry can quantify the impact of heterogeneous radiopharmaceutical distributions in organs, lesions and tissues. We analysed the influence of radionuclide voxel S factors in 3D dosimetry of (111)In, (177)Lu and (90)Y, the most used radionuclides in Peptide Receptor Radionuclide Therapy (PRRT)...
September 19, 2016: Physica Medica: PM
Nicola Fazio, Massimo Milione
Gastroenteropancreatic (GEP) neuroendocrine neoplasms (NENs) are currently classified as grade (G) 1, G2 and G3, in accordance with the 2010 WHO classification. G1 and G2 are named neuroendocrine tumors (NETs) whereas G3 neuroendocrine carcinomas (NECs). While advanced G1 and G2 are usually treated with several different therapies, including somatostatin analogs, chemotherapy, interferon, molecular targeted agents, peptide receptor radionuclide therapy (PRRT) and liver-directed treatments, advanced G3 NECs are usually treated with a platinum-etoposide chemotherapy, trusting their clinical homogeneity is similar to that of small cell lung cancer...
August 28, 2016: Cancer Treatment Reviews
Tetsuhide Ito, Lingaku Lee, Robert T Jensen
INTRODUCTION: Neuroendocrine tumors(NETs), once thought rare, are increasing in frequency in most countries and receiving increasing-attention. NETs present two-treatment problems. A proportion is aggressive and a proportion has a functional, hormone-excess-state(F-NET) each of which, must be treated. Recently, there have been many advances, well-covered in reviews/consensus papers on imaging-NETs; new, novel anti-tumor treatments and understanding their pathogenesis. However, little attention has been paid to advances in the treatment of the hormone-excess-state...
September 16, 2016: Expert Opinion on Pharmacotherapy
Sandip Basu, Preeti Fargose
The potential of peptide receptor radionuclide therapy (PRRT) is described in recurrent inoperable phosphaturic mesenchymal tumor involving left basi-occiput causing tumor-induced osteomalacia (TIO), for which the patient had undergone two times surgery previously. Following one cycle of PRRT, there was good symptomatic improvement, modest reduction of uptake on both (68)Ga-DOTATATE PET/CT and FDG-PET/CT suggesting favourable response and hence was considered for second cycle. Being somatostatin receptor avid, this rare group of tumors when inoperable or recurrent may be potentially targeted with PRRT...
September 15, 2016: Journal of Nuclear Medicine Technology
Flavia Valtorta, Fabio Benfenati, Federico Zara, Jacopo Meldolesi
In the past few years, proline-rich transmembrane protein (PRRT)2 has been identified as the causative gene for several paroxysmal neurological disorders. Recently, an important role of PRRT2 in synapse development and function has emerged. Knock down of the protein strongly impairs the formation of synaptic contacts and neurotransmitter release. At the nerve terminal, PRRT2 endows synaptic vesicle exocytosis with Ca(2+) sensitivity by interacting with proteins of the fusion complex and with the Ca(2+) sensors synaptotagmins (Syts)...
October 2016: Trends in Neurosciences
Emilio Bertani, Nicola Fazio, Davide Radice, Claudio Zardini, Chiara Grana, Lisa Bodei, Luigi Funicelli, Carlo Ferrari, Francesca Spada, Stefano Partelli, Massimo Falconi
BACKGROUND: A low burden of disease represents an independent favorable prognostic factor of response to peptide receptor radionuclide therapy (PRRT) in patients affected by gastro-entero-pancreatic neuroendocrine tumors. However, it is not clear whether this is due to a lower diffusion of the disease or thanks to debulking surgery. METHODS: From 1996 to 2013 those patients diagnosed with G1-G2 pancreatic neuroendocrine tumor (PNET) and synchronous liver metastases who were not deemed eligible for liver radical surgery but were eligible to receive upfront PRRT were prospectively included in the study...
September 9, 2016: Annals of Surgical Oncology
Chalermrat Kaewput, Sobhan Vinjamuri
BACKGROUND: Ga-DOTA-conjugated peptide PET/CT is used widely for diagnosis and treatment planning in patients with neuroendocrine tumours. As nephrotoxicity is a major limiting factor during peptide receptor radionuclide therapy (PRRT), it is important to evaluate renal function before, during and after treatment. The aim of our study is to compare renal uptake of Ga-DOTANOC and estimated glomerular filtration rate (eGFR) before and after PRRT and to identify any surrogate indicators of renal toxicity...
September 8, 2016: Nuclear Medicine Communications
Julie Nonnekens, Melissa van Kranenburg, Cecile E M T Beerens, Mustafa Suker, Michael Doukas, Casper H J van Eijck, Marion de Jong, Dik C van Gent
Metastases expressing tumor-specific receptors can be targeted and treated by binding of radiolabeled peptides (peptide receptor radionuclide therapy or PRRT). For example, patients with metastasized somatostatin receptor-positive neuroendocrine tumors (NETs) can be treated with radiolabeled somatostatin analogues, resulting in strongly increased progression-free survival and quality of life. There is nevertheless still room for improvement, as very few patients can be cured at this stage of disease. We aimed to specifically sensitize replicating tumor cells without further damage to healthy tissues...
2016: Theranostics
Belkis Erbas, Murat Tuncel
Theranostics labeled with Y-90 or Lu-177 are highly efficient therapeutic approaches for the systemic treatment of various cancers including neuroendocrine tumors and prostate cancer. Peptide receptor radionuclide therapy (PRRT) has been used for many years for metastatic or inoperable neuroendocrine tumors. However, renal and hematopoietic toxicities are the major limitations for this therapeutic approach. Kidneys have been considered as the "critical organ" because of the predominant glomerular filtration, tubular reabsorption by the proximal tubules, and interstitial retention of the tracers...
September 2016: Seminars in Nuclear Medicine
Wolfgang Peter Fendler, Martin Barrio, Claudio Spick, Martin Allen-Auerbach, Valentina Ambrosini, Matthias Benz, Christina Bluemel, Ravinder Grewal, Constantin Lapa, Matthias Miederer, Guillaume Nicolas, Tibor Schuster, Johannes Czernin, Ken Herrmann
: We evaluated the observer agreement for (68)Ga-DOTATATE PET/CT study interpretations in patients with neuroendocrine tumors (NET). METHODS: (68)Ga-DOTATATE PET/CT was performed in 50 patients with known or suspected NET of the small bowel (n = 19), pancreas (n = 14), lung (n = 4) or other location (n = 13). Images were reviewed by seven observers who used a standardized approach for image interpretation. Observers were classified as having low (<500 scans or <5 years experience with (68)Ga-DOTATATE PET/CT; n = 4) or high level of experience (≥500 scans and ≥5 years experience with (68)Ga-DOTATATE PET/CT; n = 3)...
August 18, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Çiğdem Soydal, Ahmet Peker, Elgin Özkan, Özlem Nuriye Küçük, Metin Kemal Kir
BACKGROUND/AIM: To describe the role of baseline gallium (Ga)-68 DOTATATE positron emission tomography (PET)/computed tomography (CT) in the prediction of the response to peptide receptor radionuclide therapy (PRRT) using lutetium (Lu)-177 DOTATATE. MATERIALS AND METHODS: Analysis was made of baseline Ga-68 DOTATATE PET/CT images of 29 patients (17 females and 12 males; mean age: 50.7 ± 14.6 years) with metastatic neuroendocrine tumors who received PRRT with Lu-177 DOTATATE...
2016: Turkish Journal of Medical Sciences
Giuseppe Lo Russo, Sara Pusceddu, Natalie Prinzi, Martina Imbimbo, Claudia Proto, Diego Signorelli, Milena Vitali, Monica Ganzinelli, Marco Maccauro, Roberto Buzzoni, Ettore Seregni, Filippo de Braud, Marina Chiara Garassino
Well-differentiated bronchial neuroendocrine tumors (B-NETs) are rare. They represent 1-5 % of all lung cancers. The incidence of these neoplasms has risen over the past 30 years and, especially for advanced or metastatic disease, management is complex and requires a multidisciplinary approach. Treatment with somatostatin analogs (SSAs) is the most important first-line therapy, in particular in well-differentiated NETs with high somatostatin type receptor (SSTR) expression. In these tumors, the role of mammalian target of rapamycin (m-TOR) inhibitors and the potential utility of other target therapies remain unclear while chemotherapy represents the gold standard treatment only for aggressive forms with low SSTR expression...
July 27, 2016: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Murali Kesavan, J Harvey Turner
AIM: This review of the literature, and the authors' own decade of experience with lutetium-177-octreotate-capecitabine±temozolomide peptide receptor radionuclide therapy (PRRT)-chemotherapy of GEPNETs, analyses the risk of both short- and long-term hematotoxicity. BACKGROUND: Myelodysplastic syndrome (MDS) and acute leukemia (AL) have been associated with PRRT in heavily pretreated patients with a history of exposure to alkylating agents. Commenced 15 years ago, PRRT is now becoming established as first- and second-line therapy for gastroentero pancreatic neuroendocrine tumors (GEPNETs), and early treatment minimizes myelotoxicity, which is the most significant potential adverse event following PRRT...
August 2016: Cancer Biotherapy & Radiopharmaceuticals
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