The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours

摘要: Peptide receptor radionuclide therapy (PRRNT) is a molecularly targeted radiation involving the systemic administration of radiolabelled peptide designed to target with high affinity and specificity receptors overexpressed on tumours. PRRNT employing radiotagged somatostatin agonists 90Y-DOTATOC ([90Y-DOTA0,Tyr3]-octreotide) or 177Lu-DOTATATE ([177Lu-DOTA0,Tyr3,Thr8]-octreotide [177Lu-DOTA0,Tyr3]-octreotate) have been successfully used for past 15 years metastatic inoperable neuroendocrine tumours expressing subtype 2. Accumulated evidence from clinical experience indicates that these can be subjected absorbed dose which leads partial complete objective responses in up 30 % treated patients. Survival analyses indicate patients presenting tumour expression at study entry receiving treatment show significantly higher responses, leading longer survival improved quality life. Side effects are typically seen kidneys bone marrow. These, however, usually mild provided adequate protective measures undertaken. Despite large body regarding efficacy safety, still considered an investigational its implementation must comply national legislation, ethical guidelines concerning human therapeutic investigations. This guidance was formulated based recent literature experts’ opinions. It covers rationale, indications contraindications PRRNT, assessment response patient follow-up. document aimed guiding nuclear medicine specialists selecting likely candidates receive deliver safe effective manner. largely book published through joint international effort under auspices Nuclear Medicine Section International Atomic Energy Agency.