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The effect of long-acting somatostatin analogues on the uptake of [177Lu]Lu-HA-DOTATATE

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Abstract

Purpose

According to IAEA/EANM/SNMMI guidelines, long-acting somatostatin analogues (LA-SSAs) should be discontinued 4–6 weeks prior to peptide receptor radionuclide therapy (PRRT) to prevent somatostatin receptor saturation. The aim of this study was to determine the effect of continued use of long-acting SSAs during PRRT on the uptake of [177Lu]Lu-HA-DOTATATE on SPECT/CT.

Methods

Consecutive patients with neuroendocrine tumours who were treated with PRRT receiving 7.4 GBq of [177Lu]Lu-HA-DOTATATE were included. Patients were divided into 3 groups: (1) control (LA-SSA stopped > 6 weeks prior to PRRT), or continued treatment with (2) long-acting octreotide < 6 weeks prior to PRRT, or (3) long-acting lanreotide < 6 weeks prior to PRRT. The uptake of [177Lu]Lu-HA-DOTATATE was quantified in healthy tissues (spleen, liver, kidneys, bone marrow) and tumour lesions on SPECT/CT performed 24 h after PRRT. A Mann–Whitney U test was used to determine differences in uptake between the long-acting octreotide and long-acting lanreotide groups compared to the control group.

Results

Forty-two patients with 135 cycles of PRRT were included: 28 with lanreotide, 50 with octreotide, and 57 cycles without LA-SSAs. Uptake of [177Lu]Lu-HA-DOTATATE was significantly decreased in liver parenchyma in patients with lanreotide (p < 0.001) and in the spleen in patients with either octreotide or lanreotide (both p < 0.001). No differences were observed for uptake in kidneys, bone marrow, and blood pool. Uptake of [177Lu]Lu-HA-DOTATATE in tumours was the same in patients with lanreotide compared to the control (p = 0.862) and in patients with octreotide compared to the control (p = 0.201), independent of tumour location.

Conclusion

Long-acting octreotide and lanreotide do not interfere with the uptake of [177Lu]Lu-HA-DOTATATE in tumour lesions 24 h post-injection. Uptake in healthy liver parenchyma significantly decreases after lanreotide administration prior to PRRT, while uptake in healthy spleen tissue significantly decreases with both octreotide and lanreotide administration.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Nuclear Medicine, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    Chayenne H. A. M. Veerman, Hinke Siebinga, Daphne M. V. de Vries-Huizing, Jeroen J. M. A. Hendrikx, Marcel P. M. Stokkel & Else A. Aalbersberg

  2. Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Hinke Siebinga & Jeroen J. M. A. Hendrikx

  3. Department of Medical and Gastrointestinal Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Margot E. T. Tesselaar

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Chayenne Veerman, Hinke Siebinga, and Else Aalbersberg. The first draft of the manuscript was written by Chayenne Veerman and Else Aalbersberg and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Daphne M. V. de Vries-Huizing.

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Ethics approval

This retrospective study was approved by the Institutional Research Board (IRBd21-187, approved July 26, 2021].

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Veerman, C.H.A.M., Siebinga, H., de Vries-Huizing, D.M.V. et al. The effect of long-acting somatostatin analogues on the uptake of [177Lu]Lu-HA-DOTATATE. Eur J Nucl Med Mol Imaging 50, 1434–1441 (2023). https://doi.org/10.1007/s00259-022-06094-z

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