Dual‑targeted radioligand therapy with [ 177 Lu]Lu‑DOTATATE plus [ 177 Lu]Lu‑DOTA‑IBA for bone metastases from neuroendocrine neoplasms: a prospective pilot study.
Shumao Zhang, Jia Deng, Na Zhang et al.
✦ AI-curated · Sources linked
In 30 seconds
This prospective, single-centre, single-arm pilot study evaluated combined [177Lu]Lu-DOTATATE and [177Lu]Lu-DOTA-IBA in 30 patients with neuroendocrine neoplasms and bone metastases. Across 95 treatment cycles, the reported overall bone pain relief rate was 95.9%, with complete pain resolution in 41.7% of patients. Among 24 evaluable patients, objective response rates varied by assessment method: 16.7% by RECIST 1.1, 50% by SSTR-PERCIST, and 29.2% by modified M.D. Anderson criteria. No grade ≥ 4 adverse events occurred. The findings support feasibility and preliminary activity, not definitive efficacy.
Key findings
- Overall bone pain relief was 95.9%; complete pain resolution occurred in 41.7% of patients.
- Among 24 evaluable patients, objective response rates were 16.7% by RECIST 1.1, 50% by SSTR-PERCIST, and 29.2% by modified M.D. Anderson criteria.
- No grade ≥ 4 adverse events occurred, and absorbed doses to critical organs remained within safe thresholds.
- Disease control rates were 79.2% by RECIST 1.1, 79.2% by SSTR-PERCIST, and 87.5% by modified M.D. Anderson criteria.
Why it matters
Bone metastases can cause substantial pain in neuroendocrine neoplasms. This pilot reports pain relief alongside imaging responses with a dual-targeted radioligand approach, while also describing tolerability. Response estimates differed across assessment criteria, underscoring that outcomes depend on the measure used. The results provide preliminary clinical evidence but do not establish comparative benefit or definitive antitumour efficacy.
What to keep in mind
The study was single-centre and single-arm, with a limited sample; only 24 of 30 patients were evaluable for response. The authors state that larger controlled trials are needed to confirm antitumour efficacy.