Treatment With 90Y/177Lu-DOTATOC in Patients With Metastatic Adrenocortical Carcinoma Expressing Somatostatin Receptors

Salvatore Grisanti; Angelina Filice; Vittoria Basile; Deborah Cosentini; Ida Rapa; Domenico Albano; Alessandra Morandi; Marta Laganà; Alberto Dalla Volta; Francesco Bertagna; Guido M A Tiberio; Marco Volante; Massimo Terzolo; Annibale Versari; Alfredo Berruti

doi:10.1210/clinem/dgz091

Treatment With 90Y/177Lu-DOTATOC in Patients With Metastatic Adrenocortical Carcinoma Expressing Somatostatin Receptors

J Clin Endocrinol Metab. 2020 Mar 1;105(3):dgz091. doi: 10.1210/clinem/dgz091.

Authors

Affiliations

¹ Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia. ASST Spedali Civili, Brescia, Italy.
² Nuclear Medicine Unit, Azienda Unità Sanitaria Locale - Istituto di Ricovero e Cura a Carattere Scientifico of Reggio Emilia, Reggio Emilia, Italy.
³ Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy.
⁴ Pathology Unit, Department of Oncology, S Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy.
⁵ Nuclear Medicine Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, ASST Spedali Civili, Brescia, Italy.
⁶ Surgical Clinic, Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili, Brescia, Italy.

PMID: 31633759
DOI: 10.1210/clinem/dgz091

Abstract

Context: We investigated the role of Gallium 68 dodecanetetraacetic acid Tyr3-octreotide (68Ga-DOTATOC) positron emission tomography/computed tomography (PET/CT) in detecting somatostatin receptors (SSTRs) in 19 patients with metastatic adrenocortical carcinoma (ACC) and explored the activity of yttrium-90/lutetium-177 (90Y/177Lu-DOTATOC) peptide receptor radionuclide therapy (PRRT).

Case description and methods: 68Ga uptake in metastatic sites was scored in terms of intensity and anatomical uptake distribution of standard uptake value (SUV). Tissue expression of SSTR2A and SSTR5 was also evaluated by immunohistochemistry (IHC) on primary tumors. Eight (42%) patients displayed radiometabolic uptake of any-grade intensity with focal and limited distribution. Two (11%) patients displayed strong uptake in multiple lesions and were treated with PRRT. Both obtained an overall disease control lasting 4 and 12 months, respectively.

Conclusions: ACC can express SSTRs as detected by IHC and 68Ga-DOTATOC PET. SSTRs-based PRRT may represent a potential treatment opportunity for a minority of patients with advanced ACC. This treatment modality deserves further investigation.

Keywords: adrenocortical carcinoma; metastases; peptide receptor radionuclide therapy; somatostatin.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Adrenal Cortex Neoplasms / metabolism
Adrenal Cortex Neoplasms / pathology
Adrenal Cortex Neoplasms / radiotherapy*
Adrenocortical Carcinoma / metabolism
Adrenocortical Carcinoma / pathology
Adrenocortical Carcinoma / radiotherapy*
Adult
Female
Follow-Up Studies
Humans
Male
Middle Aged
Octreotide / analogs & derivatives*
Octreotide / therapeutic use
Prognosis
Prospective Studies
Receptors, Somatostatin / metabolism*
Yttrium Radioisotopes / therapeutic use*

Substances

177Lu-octreotide, DOTA(0)-Tyr(3)-
Receptors, Somatostatin
Yttrium Radioisotopes
Yttrium-90
Octreotide

Associated data

EudraCT/2015-005546-63