Evidence map›Paper›PMID 42402519›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2026

Efficacy of peptide receptor radionuclide therapy in patients with oligodiscordant gastroenteropancreatic neuroendocrine tumours.

Claire Mok, Wallace Chow, Zahra Sabahi, Elizabeth J Bernard, Paul J Roach, Dale L Bailey, Connie I Diakos, Nick Pavlakis, David L Chan

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Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Claire MokDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia.
Wallace ChowDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia.
Zahra SabahiDepartment of Nuclear Medicine, Royal North Shore Hospital, Sydney, NSW, Australia.
Elizabeth J BernardFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Paul J RoachFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Dale L BaileyFaculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Connie I DiakosDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia.
Nick PavlakisDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia.
David L ChanDepartment of Medical Oncology, Royal North Shore Hospital, Sydney, NSW, Australia. dlhchan1@gmail.com.ORCID http://orcid.org/0000-0002-7773-3144

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of peptide receptor radionuclide therapy (PRRT) is well established in the treatment of advanced or unresectable neuroendocrine tumours (NETs) after progression on somatostatin analogues (SSA), with randomised clinical trials such as NETTER-1 and NETTER-2 showing improvement in progression free survival (PFS) as well as tumour response [12, 13]. Current landmark trials only considered patients suitable for PRRT if all known lesions displayed SSTR expression, via avidity on planar scintigraphy or Gallium-68 DOTATATE PET/CT. However, there is a select group of patients with oligodiscordant disease (3 or less lesions which are FDG avid but not DOTATATE avid) on dual DOTATATE/FDG PET imaging who may benefit from PRRT in combination with additional therapies such as liver directed therapy (LDT) or chemotherapy. There is currently no data regarding the efficacy and outcomes of PRRT in oligodiscordant disease. This study is the first to describe the treatment patterns and outcomes of patients with oligodiscordant disease receiving PRRT.

methodsA single-centre retrospective review was performed in patients with advanced gastroenteropancreatic NETs with oligodiscordant disease who received at least one cycle of PRRT with [177Lu]Lu-DOTA-TATE from 2020 to 2024. Safety was assessed by renal and haematological parameters (CTCAE v5.0) during PRRT, and at 3 months post completion of treatment. Response to treatment was evaluated on molecular imaging with Gallium-68 DOTATATE PET/CT. Kaplan-Meier method was used to perform median progression free survival (PFS), overall survival (OS), and time to next treatment (TTNT) analyses.

resultsThirteen patients met the inclusion criteria, the median age was 66 years, and 54% were male. Primary site: small bowel (7), pancreas (4), colorectal (2). WHO grade: none had grade 1 disease, ten grade 2 and three had grade 3 disease. Median OS was 27.3 months (95% CI 19.7 - not reached), median PFS 15.1 months (95% CI 7.1-20.1), and median TTNT 15.0 months (95% CI 6.7-39.6). One of 15 patients developed treatment related myeloid neoplasm on long term follow-up, confirmed by bone marrow biopsy. No patients developed significant renal toxicity on follow-up.

conclusionIn patients with advanced NETs with oligodiscordant disease identified on dual PET imaging, the combination of PRRT with systemic therapy or other therapies (surgery, liver directed therapy, radiotherapy) can be effective with acceptable toxicity and should be considered as a possible option for treatment in selected patients. The sequencing of treatment modalities and exact strategy employed is best decided at an experienced NET centre with multi-disciplinary input.

Indexed as

Intestinal NeoplasmsNeuroendocrine TumorsPancreatic NeoplasmsReceptors, PeptideStomach NeoplasmsAdultAgedFemaleHumansMaleMiddle AgedOctreotideOrganometallic CompoundsPositron Emission Tomography Computed TomographyRetrospective StudiesTreatment OutcomeOctreotideOrganometallic CompoundsReceptors, PeptideDiscordant diseaseDotatate PETDOTATATE PETFDG avid diseaseFDG PETNeuroendocrine tumoursOverall survivalPeptide receptor radionuclide therapyProgression free survivalProgression free survival FDG avid disease.

Identifiers

PMID42402519
PMCPMC13633385

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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.