Peptide receptor radionuclide therapy in malignant insulinoma
- Author(s)
- Pattison, DA; Kong, G; Akhurst, T; Burge, M; Chiang, C; Hofman, MS; Hung, TJ; Love, A; Michael, M; Okano, S; Ravi Kumar, AS; Sachithanandan, N; Wyld, D; Hicks, RJ;
- Details
- Publication Year 2025-05-01,Volume 32,Issue #6,Page e250018
- Journal Title
- Endocrine-Related Cancer
- Publication Type
- Online publication before print
- Abstract
- Management of malignant insulinoma (MI) presents dual management challenges of hypoglycaemia and tumour control. This study aims to analyse long-term outcomes of PRRT for treatment of MI. We retrospectively reviewed consecutive patients with MI treated with [177Lu]Lu-DOTATATE (LuTATE) at two Australian NET centres between 2004-2022. Follow-up for hypoglycaemia, molecular imaging, radiologic and biochemical responses, treatment-related side-effects, progression free- and overall-survival were assessed. Of 15 patients (7 female; median age 60, range 26-82) treated for intractable hypoglycaemia WHO Grade (G) was known in 12 patients (3 G1, 6 G2 and 3 G3). PRRT was administered median 7 cycles (range 1-15) with median cumulative activity 42GBq (range 4-117GBq) and radiosensitizing chemotherapy in 9/15 (60%). Resolution of hypoglycaemia was observed in 14/15 (93%) patients after median 2.5 months (range 0.2-23.5) but recurred in 7/14 cases after median 17.7 months (range 7.6-48.3). Patients with recurrent hypoglycaemia had longer time to hypoglycaemia resolution (median 3.0 vs 0.5 months), were more likely G3 (57% vs 0%) and experienced higher mortality (86% vs 29%). In all 7 cases, PRRT re-treatment was successful. Duration of hypoglycaemia remission was median 23.8 months (range 9.2-101). Median progression free- and overall-survival was 17.9 months (95% CI, 8.5-43.2) and 50.1 months (95% CI, 23.0-ND) respectively. Side-effects included G3/4 myelosupression in 4/15 patients, and hypoglycaemia flare (hospitalisation >48 hours) in 7/15 patients. PRRT provides durable hypoglycaemic and oncologic disease control of MI with manageable toxicity including hypoglycaemia flare requiring multidisciplinary care.
- Publisher
- Bioscientifica
- Department(s)
- Cancer Imaging; Internal Medicine; Medical Oncology
- Publisher's Version
- https://doi.org/10.1530/erc-25-0018
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-06-26 04:30:36
Last Modified: 2025-06-26 04:31:07