Dosing 225Ac-DOTATOC in patients with somatostatin-receptor-positive solid tumors: 5-year follow-up of hematological and renal toxicity

The aim of this retrospective analysis is to estimate the most appropriate single cycle and cumulative doses of 225Ac- DOTATOC in patients treated for somatostatin-receptor-expressing cancers. 225Ac-DOTATOC was administered to thirty-nine patients with various somatostatin-receptor-positive tumors. Baseline and follow-up 68Ga-DOTATOC PET/CT, lab tests, and renal scintigraphy were obtained. Patients received longterm follow-up either at the local cancer center or in close collaboration with external oncologists. Acute and chronic hematological toxicity was evaluated quantitatively over time. Long-term follow-up of creatinine was used to approximate the annual loss of estimated GFR (eGFR). Dose-dependent acute hematological toxicity was seen at single doses above 40 MBq or repeated doses greater than approximately 20 MBq 225Ac-DOTATOC at 4 month intervals. Treatment-related kidney failure occurred in 2 patients after a delay of >4 years but was independent of administered radioactivity, and other clinical risk factors were important contributors to renal decline. In general, the annual decline of eGFR among patients did not follow a clear dose-effect relationship even in patients with previous β-therapy. An average eGFR-loss of 8.4ml/min (9.9%) per year was observed which is similar to the experience with β-therapy studies.

KRATOCHWIL Clemens;  APOSTOLIDIS Leonidas;  RATHKE H;  APOSTOLIDIS C.;  BICU Felix;  BRUCHERTSEIFER Frank;  CHOYKE Peter L.;  HABERKORN Uwe;  GIESEL Frederik;  MORGENSTERN Alfred; 

2022-03-16

SPRINGER

JRC125024

1619-7070 (online),   

https://link.springer.com/article/10.1007/s00259-021-05474-1,    https://publications.jrc.ec.europa.eu/repository/handle/JRC125024,   

10.1007/s00259-021-05474-1 (online),