Holmium-166 radioembolisation after peptide receptor radionuclide therapy: much needed data to help inform future research
Mené sur 30 patients présentant des métastases hépatiques ayant pour origine une tumeur neuroendocrine (durée de suivi : 6 mois), cet essai de phase II évalue l'intérêt, du point de vue de la sécurité et de la disparition complète ou partielle des lésions cancéreuses, d'une radioembolisation hépatique utilisant l'holmium-166 après quatre cycles d'un traitement par le lutétium-177-dotatate
First-line treatment with somatostatin analogues is recommended for patients with gastroenteropancreatic well-differentiated neuroendocrine tumours that are somatostatin receptor avid. At diagnosis, 21–50% of patients with well-differentiated neuroendocrine tumours have distant metastases, with the liver being the most commonly affected organ. Lutetium-177-dotatate ( 177Lu-dotatate) peptide receptor radionuclide therapy (PRRT) has been shown to dramatically improve progression-free survival in patients with liver metastases without substantial hepatotoxicity; however, the extent of the PRRT benefit might be reduced for patients with bulky liver metastases. The objective response to PRRT was 18% in patients with advanced, progressive, midgut neuroendocrine tumours in the NETTER-1 trial. Objective response and duration of liver disease response might be improved by offering liver-directed therapy after PRRT. In The Lancet Oncology, Arthur Braat and colleagues presented the results of a prospective phase 2 trial that described short-term safety and efficacy of holmium-166 microsphere radioembolisation following PRRT in 30 patients with well-differentiated neuroendocrine tumour liver metastases.
The Lancet Oncology , commentaire, 2019