Personalized Thera(g)nostic Approach in Patients with Paraganglioma: Peptide Receptor Radionuclide Therapy

Bernhard Nilica, Hanna Svirydenka, Christian Mair, Alexander Stephan Kroiss, Michael Gabriel and Irene Virgolini

Department of Nuclear Medicine, Medical University Innsbruck, Austria
Institute of Nuclear Medicine and Endocrinology, Kepler University Hospital, Linz, Austria

^*Correspondance to: Bernhard Nilica 

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Abstract:

Objective: The experience with Somatostatin-Receptor (SSTR) based Peptide-Radionuclide Therapy (PRRT) in patients with Paraganglioma (PGL) is limited. We report our experience for the treatment of malignant PGL. Material and methods: Nineteen patients with PGL, who were treated with 90Y-DOTATOC/177Lu-DOTATATE, were  retrospectively reviewed. Response to treatment was evaluated by RECIST 1.0/PERCIST 1.1 criteria.
Results: Of the 19 patients, 6 were male and 13 females, ages ranged from 18 to 74 years at initial diagnosis. Pre-therapeutic scanning was positive in 19/19 PGL-patients with 68Ga-DOTATOC from whom 13/19 patients received 90Y-DOTATOC (ACA (accumulated activity) range 8.07-16.44 GBq, ATD (accumulated tumour dose) range 4.6 Gy to 152.8 Gy), 4/19 patients 177Lu-DOTATATE (ACA range 8.49 GBq to 55.42 GBq, ATD range 14.1 Gy to 235.3 Gy). In two patients no therapy could be applied. The median PFS and OS was 96 (range 10 to 180) and 99.5 (range 24 to 180) months, respectively.
Conclusion: Both 90Y/177Lu-SSTR-targeting peptides may be useful for long-term disease control in patients with locally advanced or metastatic paraganglioma when applied in several treatment cycles that may reach meaningful absorbed tumour doses. Pretherapeutic scanning for a tailored treatment regimen seems appropriate in order to identify the radiopharmaceutical with highest tumour uptake.

Keywords:

Paraganglioma; ¹³¹I-mIBG; Somatostatin; PRRT

Cite the Article:

Nilica B, Svirydenka H, Mair C, Stephan Kroiss A, Gabriel M, Virgolini I. Personalized Thera(g)nostic Approach in Patients with Paraganglioma: Peptide Receptor Radionuclide Therapy. Clin Oncol. 2021;6:1824..