Post on 05-Jan-2016
transcript
177177Lu-Dota-NOCateLu-Dota-NOCate &&
177177Lu-Dota-GastrinLu-Dota-Gastrin in in
Metastatic Medullary Thyroid CancerMetastatic Medullary Thyroid Cancer
Clinic of Endocrinology, Inst. of Nuclear Medicine, University Hospital, Basel, CH
For Questions contact:
Beat Müller, happymiller@bigfoot.com
Martin A. Walter, m.a.walter@gmx.net
Medullary Thyroid Cancer
Treatment Options:
- Surgery (first line)
- To date no effective systemic treatment option
- Radiation Therapy is not well defined
- Treatment options with different Radiopeptides are currently evaluated
Aim
To assess the value of177Lu-Dota-NOCate and 177Lu-Dota-Gastrin
in Imaging and Treatment of
Metastatic Medullary Thyroid Cancer
Ethically Approved (EKBB)
Radiopeptides
Target
Somatostatin/
CCK2-Receptor
Ligand
Somatostatin/
Gastrin-Analogs
Signal
177Lu
„Magic Bullet“ Approach
Application Distribution Accumulation
Tumor
Metastases
Affinity Profile (Dota-NOC-ATE)
Receptor Profile (MTC)
EB Forssell-Aronsson. J Nucl Med 2000;41:636–642
Pilot-Patient (Dota-NOC-ATE)
SpecificTumor Uptake(LN-metastesis)
p9581♂, 63yMetastised MTC
Patients
Patients with progressive MTC
Exclusion criteria:
• Karnofsky Performance Status < 50%
• Refusion of a 1-year contraception
• Pregnancy
• Breast-feeding
• Age<18
Diagnostic Scintigraphy
• Scintigraphy + Dosimetry
(first compound, outpatient, 2d)
• Scintigraphy + Dosimetry
(second compound, outpatient, 2d)
2 weeks later
• Significant Accumulation
+ Favorable Biodistribution → Treatment
Treatment
• Inpatient
• 3 Days
• Day 1: Injection of Radiopeptide
+ Amino Acid Infusion (Kidney Protection)
• Day 2: Imaging
• Day 3: Release of Patient