scholarly journals Metastatic Insulinoma Managed with Radiolabeled Somatostatin Analog

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ricardo Costa ◽  
Rubens Costa ◽  
Carlos E. Bacchi ◽  
Paulo Almeida Filho
Keyword(s):  
Glycemic Control ◽  
Metastatic Disease ◽  
Somatostatin Receptor ◽  
Pancreatic Neuroendocrine Tumor ◽  
Predictive Marker ◽  
Disease Diagnosis ◽  
Somatostatin Analog ◽  
Intravenous Glucose ◽  
Positron Emission ◽  
Radiolabeled Somatostatin Analog

Insulinoma is a rare pancreatic neuroendocrine tumor. Overproduction of insulin and associated hypoglycemia are hallmark features of this disease. Diagnosis can be made through demonstration of hypoglycemia and elevated plasma levels of insulin or C-Peptide. Metastatic disease can be detected through computerized tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT. Somatostatin receptor scintigraphy can be used not only to document metastatic disease but also as a predictive marker of the benefit from therapy with radiolabeled somatostatin analog. Unresectable metastatic insulinomas may present as a major therapeutic challenge for the treating physician. When feasible, resection is the mainstay of treatment. Prevention of hypoglycemia is a crucial goal of therapy for unresectable/metastatic tumors. Diazoxide, hydrochlorothiazide, glucagon, and intravenous glucose infusions have been used for glycemic control yielding temporary and inconsistent results. Sandostatin and its long-acting depot forms have occasionally been used in the treatment of Octreoscan-positive insulinomas. Herein, we report a case of metastatic insulinoma with very difficult glycemic control successfully treated with the radiolabeled somatostatin analog lutetium (177LU).

Targeted radiopeptide therapy Re188-P2045 to treat neuroendocrine lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20016-e20016
Author(s):  
Christopher Peter Adams ◽  
Wasif M. Saif
Keyword(s):  
Lung Cancer ◽  
Image Analysis ◽  
Cancer Patients ◽  
Lung Tumor ◽  
Somatostatin Receptor ◽  
Receptor Expression ◽  
Somatostatin Analog ◽  
Receptor Subtype ◽  
Lung Cancer Patients ◽  
Radiolabeled Somatostatin Analog

e20016 Background: : Despite the recent success of checkpoint inhibitors, there continues to be a significant medical need for lung cancer therapies that can be directed to the patients most likely to respond. Somatostatin receptor subtype 2 (SSTR2) is the most widely up-regulated subtype in both small and non-small cell lung cancers and is also expressed in tumoral (but not mature) blood vessels. Peptide targeted radiotherapy has advantages over traditional targeted therapies in that targeted tumor cells as well as surrounding cancer cells and supporting stroma are selectively killed. This study was conducted to determine the ability of Rhenium Re 188 P2045, a radiolabeled somatostatin analog specific for SSTR2 to both image (to select the most appropriate patients) and treat lung cancer patients who over-express somatostatin receptors. Methods: In an open label, single arm study, refractory lung cancer patients to standard of care therapy were identified by image analysis using Rhenium Re 188 P2045, a radiolabeled somatostatin analog. 25 Patients received the imaging dose of 10uCi of Re188 and 265ng of peptide by intravenous injection. Three patients were selected based on high SSTR expression levels to receive 30uCi of Re188 P2045 as a therapeutic dose 14 days after imaging. Patients were followed for 8 weeks post treatment. Results: The imaging study revealed a high density of expression of the somatostatin receptor in the lungs of patients. Patients in the imaging and therapeutic treatment groups reported no adverse advents or signs of toxicity. The image analysis using Re188 P2045 was compared to CT images and demonstrated accurate detection of lung tumor lesions. The images obtained using Re188 P2045 were of sufficiently high quality to enable identification of receptor expression at the tumor site as shown in Figures 1&2. Conclusions: Rhenium Re 188 P2045, a radiolabeled somatostatin analog, may be used to both identify and treat lung cancer tumors. The ability to image and dose patients with the same targeted molecule enables a personalized medicine approach and this highly targeted patient therapy may significantly improve treatment of tumors that over express somatostatin receptor.

Radiolabeled Somatostatin Analog [177Lu-DOTA0,Tyr3]Octreotate in Patients With Endocrine Gastroenteropancreatic Tumors

2005 ◽  
Vol 23 (12) ◽  
pp. 2754-2762 ◽  
Author(s):  
Dik J. Kwekkeboom ◽  
Jaap J. Teunissen ◽  
Willem H. Bakker ◽  
Peter P. Kooij ◽  
Wouter W. de Herder ◽  
...  
Keyword(s):  
Median Time ◽  
Tumor Regression ◽  
Somatostatin Receptor ◽  
Somatostatin Analog ◽  
Hematologic Toxicity ◽  
Receptor Imaging ◽  
Tumor Diameter ◽  
Time To Progression ◽  
Minor Response ◽  
Radiolabeled Somatostatin Analog

Purpose There are few treatment options for patients with metastasized or inoperable endocrine gastroenteropancreatic (GEP) tumors. Chemotherapy can be effective, but the response is usually less than 1 year. Here, we present the results of treatment with a radiolabeled somatostatin analog, [177Lu-DOTA0,Tyr3]octreotate (177Lu-octreotate). Patients and Methods One hundred thirty-one patients with somatostatin receptor-positive tumors were treated with up to a cumulative dose of 600 to 800 mCi (22.2 to 29.6 GBq) of 177Lu-octreotate. Results One patient developed renal insufficiency, and another patient developed hepatorenal syndrome. Creatinine clearance did not change significantly in the other patients. WHO hematologic toxicity grade 3 or 4 occurred after less than 2% of the administrations. We observed complete remission in three patients (2%), partial remission in 32 patients (26%), minor response (tumor diameter decrease of 25% to 50%) in 24 patients (19%), stable disease (SD) in 44 patients (35%), and progressive disease (PD) in 22 patients (18%). Higher remission rates were positively correlated with high uptake on pretherapy somatostatin receptor imaging and a limited number of liver metastases, whereas PD was significantly more frequent in patients with a low performance score and extensive disease. Median time to progression in 103 patients who either had SD or tumor regression was more than 36 months. Conclusion Treatment with 177Lu-octreotate results in tumor remission in a high percentage of patients with GEP tumors. Serious side effects are rare. The median time to progression compares favorably with chemotherapy. Results are better in patients with a limited tumor load. Therefore, early treatment, even in patients who have no PD, may be better.

scholarly journals A new 68Ga-labeled somatostatin analog containing two iodo-amino acids for dual somatostatin receptor subtype 2 and 5 targeting

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rosalba Mansi ◽  
Karim Abid ◽  
Guillaume P. Nicolas ◽  
Luigi Del Pozzo ◽  
Eric Grouzmann ◽  
...  
Keyword(s):  
Amino Acids ◽  
Somatostatin Receptor ◽  
Somatostatin Analog ◽  
Receptor Subtype ◽  
Somatostatin Receptor Subtype 2

Intraoperative Detection of a Bronchial Carcinoid With a Radiolabeled Somatostatin Analog

CHEST Journal ◽  
2002 ◽  
Vol 121 (3) ◽  
pp. 985-988 ◽  
Author(s):  
Jaime A. Rodriguez ◽  
Michael O. Meyers ◽  
Tomas H. Jacome ◽  
Paul Failla ◽  
Lynn H. Harrison
Keyword(s):  
Somatostatin Analog ◽  
Bronchial Carcinoid ◽  
Intraoperative Detection ◽  
Radiolabeled Somatostatin Analog

scholarly journals Prognostic Value of Volume-Based Parameters Measured by SSTR PET/CT in Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiale Hou ◽  
Yi Yang ◽  
Na Chen ◽  
Dengming Chen ◽  
Shuo Hu
Keyword(s):  
Positron Emission Tomography ◽  
Neuroendocrine Tumors ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Somatostatin Receptor ◽  
Progression Free Survival ◽  
Emission Tomography ◽  
Cochrane Library ◽  
Positron Emission ◽  
Pet Ct

Purpose: A meta-analysis was conducted to investigate the value of the volume parameters based on somatostatin receptor (SSTR)-positron emission tomography (PET) in predicting the prognosis in patients with neuroendocrine tumors (NETs).Material: PUBMED, EMBASE, Cochrane library, and Web of Knowledge were searched from January 1990 to May 2021 for studies evaluating prognostic value of volume-based parameters of SSTR PET/CT in NETs. The terms used were “volume,” “positron emission tomography,” “neuroendocrine tumors,” and “somatostatin receptor.” Pooled hazard ratio (HR) values were calculated to assess the correlations between volumetric parameters, including total tumor volume (TTV) and total-lesion SSTR expression (TL-SSTR), with progression-free survival (PFS) and overall survival (OS). Heterogeneity and subgroup analysis were performed. Funnel plots, Begg's and Egger's test were used to assess possible underlying publication bias.Results: Eight eligible studies involving 593 patients were included in the meta-analysis. In TTV, the pooled HRs of its prognostic value of PFS and OS were 2.24 (95% CI: 1.73–2.89; P < 0.00001) and 3.54 (95% CI, 1.77–7.09; P = 0.0004), respectively. In TL-SSTR, the pooled HR of the predictive value was 1.61 (95% CI, 0.48–5.44, P = 0.44) for PFS.Conclusion: High TTV was associated with a worse prognosis for PFS and OS in with patients NETs. The TTV of SSTR PET is a potential objective prognosis predictor.

Abstract 460: 64 Cu-DOTATATE for in vivo Positron Emission Tomography Imaging of Somatostatin Receptor 2 Expressing Macrophages in a Göttingen Minipig Model of Atherosclerosis

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Sune Folke Pedersen ◽  
Trine Pagh Ludvigsen ◽  
Andreas Vegge ◽  
Camilla Schumacher-Petersen ◽  
Rasmus Sejersten Ripa ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Abdominal Aorta ◽  
Right Atrium ◽  
Plasma Lipids ◽  
Somatostatin Receptor ◽  
Emission Tomography ◽  
Activated Macrophages ◽  
Lean Control ◽  
Positron Emission

Background: Somatostatin receptor subtype 2 (SSTR 2 ) is expressed by activated macrophages which are important effector cells in atherogenesis and a major constituent of atherosclerotic plaques. SSTR 2 can be targeted non-invasively in vivo using the tracer 64 Cu-DOTATATE and positron emission tomography (PET). Methods: Male castrated Göttingen minipigs were treated according to two diet regimes for 43 weeks: chow (lean control; n=1) or high-fat/high-cholesterol diet (HFHC, obese group; n=2). Plasma lipids: total cholesterol (TC) and triglycerides (TG) were measured and SSTR 2 expression was assessed using hybrid positron emission tomography/magnetic resonance (PET/MR) imaging of the abdominal aorta, one hour (range: 60-63 minutes) post injection with 200 MBq (range 202-214 MBq) of 64 Cu-DOTATATE. Consectutive regions of interest (ROIs) were drawn guided by MR to include vessel wall and lumen of the abdominal aorta to calculate standardized uptake values (SUVs). Target-to-background (TBR) ratios were calculated using right atrium SUVs for blood pool correction (SUV vessel /SUV right atrium = TBR) and reported as mean and maximal values (TBR mean ; TBR max ). Results: Three minipigs (age 17 months) were included and PET/MR was completed in all animals. Mean uptake of 64 Cu-DOTATATE was lowest for the abdominal aorta in the lean control: TBR mean = 0.44 and TBR max = 0.73 (range: TBR mean = 0.29 - 0.62; TBR max = 0.49 - 1.10) and highest in the HFHC group: TBR mean = 0.66 and TBR max = 1.28 (range: TBR mean = 0.26 - 1.38; TBR max = 0.39 - 3.19). Plasma lipids: lean control: TC = 1.34 mmol/L; TG = 0.38 mmol/L; HFHC group (mean values): TC = 18.7mmol/L (range: 11.6 - 25.8mmol/L); TG = 0.6 mmol/L (range: 0.37 - 0.83mmol/L). Conclusion: Non-invasive 64 Cu-DOTATATE PET/MR is feasible for assessment of SSTR 2 expression in a Göttingen minipig model of diet-induced atherosclerosis. Additional studies are needed including assessment of histology findings and gene expression to confirm the presence of activated macrophages in order to validate the use of 64 Cu-DOTATATE PET/MR in this model.

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