The Safety and Efficacy of the Repeated PRRT with [⁹⁰Y]Y/[¹⁷⁷Lu]Lu-DOTATATE in Patients with NET

Figure 4

Example of the effect of the repeated tandem [⁹⁰Y]Y/[¹⁷⁷Lu]Lu-DOTATATE therapy: a 51-year-old woman with a nonfunctional pancreatic G2 NET after surgery for primary tumours, with progression of the disease after 4 months. The [⁶⁸Ga]Ga-DOTATATE PET/CT carried out for qualification to the PRRT showed increased uptake (higher than in the liver) in multiple metastases in the liver and lymph node. The patient received the initial PRRT and the repeated PRRT with the total accumulated injection activity of 20.7 GBq. The PFS rate after the I-PRRT and the R-PRRT was 24 and 21 months, respectively. The disease progression after each therapy course was observed in the same parts of the body. (a) [⁶⁸Ga]Ga-DOTATATE PET MIP before the I-PRRT showing increased uptake in multiple metastases; (b) [⁶⁸Ga]Ga-DOTATATE PET MIP after the I-PRRT with complete response in the liver metastases and partial response in the lymph node; and axial fusion [⁶⁸Ga]Ga-DOTATATE PET/CT (c, d) before and (e, f) after the I-PRRT. (g) [⁶⁸Ga]Ga-DOTATATE PET MIP before the R-PRRT showing progression of the disease after the I-PRRT; (h) [⁶⁸Ga]Ga-DOTATATE PET MIP after the R-PRRT with partial response; and axial fusion [⁶⁸Ga]Ga-DOTATATE PET/CT (i, j) before and (k, l) after the R-PRRT.