Scientific Abstracts: Liver
Objective: Evaluate if patients with transarterial radioembolization (TARE) prior to peptide receptor radionuclide therapy with lutetium 177 DOTATATE (177Lu) have increased treatment-associated toxicity compared to those without prior liver directed radiation therapy.
Methods: Retrospective study of patients treated with 177Lu DOTATATE from 8/2018 to 8/2019. Included were 53 patients (29 men) with somatostatin receptor positive metastatic neuroendocrine tumors treated with up to four sessions of 177Lu; 8 underwent prior TARE. The EMR and PACS were reviewed for patient demographics, treatment dates, baseline labs, and total radiation exposure. Renal and liver function, CBC, and adverse events (CTCAE v 5.0 grade, if indicated) within 1 month of each cycle of 177Lu were recorded.
Toxicities among patients who underwent TARE were compared to those patients without TARE using Fisher’s exact, Mann-Whitney U, and one-sided trend tests.
Results: Patients who received TARE prior to 177Lu had no significant difference in baseline eGFR, creatinine, liver function (AST, ALT, Tbili, ascites), CBC, or 177Lu dose, compared to patients without prior TARE exposure (p>0.05).
The most common complication after 177Lu therapy was mild, self-resolving fatigue. One month after each 177Lu session, there was no difference in renal toxicity, hematotoxicity, or hepatoxicity among patients with prior TARE and those without (p>0.05) (Table 1).
Conclusions: In this single institution, retrospective study, treatment of neuroendocrine tumors with the radiopharmaceutical, 177Lu, appears safe in the setting of prior TARE. No significant increase in short-term treatment-related toxicities (nephrotoxicity, hematotoxicity, or hepatotoxicity) was recorded. Notable limitations include small sample size and short-term follow-up.