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

• DOI: 10.1007/s00259-021-05474-1
• Publication Date: 2021-08-26T21:02:39Z
• Authors: Clemens Kratochwil; Leonidas Apostolidis; Hendrik Rathke; Christos Apostolidis; Felix Bicu; Frank Bruchertseifer; Peter L Choyke; Uwe Haberkorn; Frederik L Giesel; Alfred Morgenstern
• Keywords: Cumulative dose; Radionuclide therapy

Abstract Purpose The aim of this retrospective analysis is to estimate the most appropriate single cycle and cumulative doses 225 Ac-DOTATOC in patients treated for somatostatin-receptor-expressing cancers. Methods was administered thirty-nine with various somatostatin-receptor-positive tumors. Baseline follow-up 68 Ga-DOTATOC PET/CT, lab tests, renal scintigraphy were obtained. Patients received long-term either at local cancer center or close collaboration external oncologists. Acute chronic hematological toxicity evaluated quantitatively over time. Long-term creatinine used approximate annual loss estimated GFR (eGFR). Results Dose-dependent acute seen above 40 MBq repeated greater than approximately 20 4 month intervals. Treatment-related kidney failure occurred 2 after a delay >4 years but independent radioactivity, other clinical risk factors important contributors decline. In general, decline eGFR among did not follow clear dose-effect relationship even previous β-therapy. An average eGFR-loss 8.4ml/min (9.9%) per year observed which similar experience β-therapy studies. Conclusion Treatment activities approx. (4 monthly repetition) up 60–80 generally avoided both grade 3/4 hematotoxicity advanced stage malignancies. Chronic these doses, pre-existing co-factors. These data represent starting point additional research more precisely define safety thresholds Ac-DOTATOC.