Evidence map›Paper›PMID 24995150›Full record

ArticleEJNMMI research2014

Peptide receptor radionuclide therapy (PRRT) with [(177)Lu-DOTA(0),Tyr(3)]octreotate in combination with RAD001 treatment: further investigations on tumor metastasis and response in the rat pancreatic CA20948 tumor model.

Sander M Bison, Stefan E Pool, Stuart J Koelewijn, Linda M van der Graaf, Harald C Groen, Marleen Melis, Marion de Jong

Open access · goldAbstract read
In one paragraph

Article in EJNMMI research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 19 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Combination Strategies to Improve Targeted Radionuclide Therapy.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2020
    Article
  6. Article
  7. Combination treatments to enhance peptide receptor radionuclide therapy of neuroendocrine tumours.European journal of nuclear medicine and molecular imaging · 2020
    Review
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Sander M BisonDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands ; Department of Radiology, Erasmus MC, Rotterdam 3000, CA, the Netherlands ; Department of Medical Informatics, Erasmus MC, Rotterdam 3000, CA, the Netherlands.
Stefan E PoolDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands.
Stuart J KoelewijnDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands.
Linda M van der GraafDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands.
Harald C GroenDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands ; Department of Radiology, Erasmus MC, Rotterdam 3000, CA, the Netherlands.
Marleen MelisDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands.
Marion de JongDepartment of Nuclear Medicine, Erasmus MC, Postbus 2040, Rotterdam 3000, CA, the Netherlands ; Department of Radiology, Erasmus MC, Rotterdam 3000, CA, the Netherlands.
Erasmus MC · NLErasmus University Rotterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPreviously, we reported on the unexpected development of distant metastases in the subcutaneous rat pancreas CA20948 tumor model after 4.5 weeks of treatment with RAD001-only or in combination with [(177)Lu-DOTA(0),Tyr(3)]octreotate ((177)Lu-DOTATATE) (Cancer Res. 73:12-8, 2013). Moreover, the combination therapy was less effective compared to (177)Lu-DOTATATE-only. In the current study, we address the following questions: (1) Why was the combination therapy less effective? Is (177)Lu-DOTATATE tumor uptake affected by pretreatment with RAD001? (2) Could sudden cessation of RAD001 therapy cause the development of distant metastases? (3) Is (177)Lu-DOTATATE an effective treatment option for these metastases?

methodsLewis rats (HanHsd or SsNHsd substrain with a slight difference in immune response) bearing subcutaneous CA20948 tumors were treated with either 125 or 275 MBq (177)Lu-DOTATATE, RAD001, or their combination. RAD001 was given twice a week for 4.5 or 12 weeks, whereas (177)Lu-DOTATATE was given as a single injection. When combined, RAD001 was started either 3 days prior to or 3 days post administration of (177)Lu-DOTATATE. SPECT/CT was performed to quantify (177)Lu-DOTATATE tumor uptake. Where indicated, primary tumors were surgically removed when tumor size is >6,000 mm(3) to enable monitoring for possible metastasis. If metastases were suspected, an (111)In-DTPA-octreotide SPECT/CT scan was performed. Seven rats with metastases were treated with 400 MBq (177)Lu-DOTATATE.

resultsLu-DOTATATE tumor uptake was not significantly affected by RAD001 pretreatment. The occurrence of metastases after RAD001 treatment was not dose dependent in the dose range tested, nor was it related to the duration of RAD001 treatment. In the experiment in which the LEW/SsNsd substrain was used, only 12.5% of RAD001-treated rats showed complete response (CR), compared to 50% tumor regression in the control group. Re-treatment with a high dose of (177)Lu-DOTATATE resulted in CR in only two out of seven animals.

conclusionLess effective anti-tumor effects after the combination of RAD001 + (177)Lu-DOTATATE could not be explained by reduced (177)Lu-DOTATATE tumor uptake after RAD001. Our current data support RAD001-induced immune suppression as the reason for this observation. No evidence was found that cessation of RAD001 treatment caused development of metastases. Metastases appeared to be less sensitive to (177)Lu-DOTATATE treatment than primary tumors.

Indexed as

177Lu-DOTATATEAffinitorEverolimusMetastasisRAD001

Identifiers

PMID24995150
PMCPMC4070081
OpenAlexW2017550948

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.