Combined 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy and Platinum-Based Chemotherapy in Recurrent, Metastatic Sinonasal Neuroendocrine Carcinoma: A Promising Therapeutic Option

J Nucl Med Technol. 2020 Sep;48(3):292-294. doi: 10.2967/jnmt.119.237354. Epub 2020 May 1.

Abstract

Sinonasal neuroendocrine carcinomas (SNCs), in contrast to neuroendocrine carcinomas at other sites, are notorious for their recurrent and locally aggressive nature. The clinical concern is primarily due to their complex anatomy and close proximity to vital structures, compounded by lack of proper understanding of pathogenesis, no definitive classification or staging system, and no established treatment guidelines. We present the promise of combined treatment with 177Lu-DOTATATE-based peptide receptor radionuclide therapy (PRRT) and platinum-based chemotherapy in a patient with high-grade, recurrent, and metastatic SNC (that demonstrated high uptake on both 68Ga-DOTATATE and 18F-FDG PET/CT), which showed a significant partial response. The case report highlights the feasibility and effectiveness of applying a combined protocol of 177Lu-DOTATATE and platinum-based chemotherapy in the management of high-grade, recurrent, metastatic SNC.

Keywords: 177Lu-DOTATATE; 18F-FDG PET/CT; 68Ga-DOTATATE PET/CT; dual-tracer PET/CT; peptide receptor radionuclide therapy; sinonasal neuroendocrine carcinoma.

Publication types

  • Case Reports

MeSH terms

  • Combined Modality Therapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neuroendocrine Tumors / diagnostic imaging
  • Neuroendocrine Tumors / drug therapy*
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / radiotherapy*
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use
  • Organometallic Compounds / therapeutic use*
  • Platinum / chemistry
  • Platinum / therapeutic use*
  • Positron Emission Tomography Computed Tomography
  • Receptors, Peptide / metabolism*
  • Recurrence
  • Treatment Outcome

Substances

  • Organometallic Compounds
  • Receptors, Peptide
  • Platinum
  • lutetium Lu 177 dotatate
  • Octreotide