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Peptide receptor radionuclide therapy of Merkel cell carcinoma using 177lutetium-labeled somatostatin analogs in combination with radiosensitizing chemotherapy: a potential novel treatment based on molecular pathology

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Abstract

Few studies have been published on the safety and feasibility of synchronous use of peptide receptor radionuclide therapy (PRRNT), as source of internal radiation therapy, in combination with chemotherapy. In this study we reported a 53-year-old man with stage IV Merkel cell carcinoma (MCC), who underwent synchronous internal radiation therapy and chemotherapy. Based on presumable poor prognosis with chemotherapy only, functional similarities of MCC with other neuroendocrine tumors and available evidence of effectiveness and safety of synchronous use of external beam radiation therapy and chemotherapy in treatment of high-risk MCC patients, our interdisciplinary neuroendocrine tumor board recommended him to add PRRNT to his ongoing chemotherapy. He received 2 courses of 177Lu-DOTATATE(1, 4, 7, 10-Tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid-1-D-Phe1-Tyr3-Thr8-octreotide) in combination with ongoing 8 cycles of liposomal doxorubicin based on standard protocols. Response to therapy was evaluated by 18F-FDG and 68gallium-somatostatin-receptor PET/CT. There was an impressive improvement of the clinical symptoms. However, follow-up PET/CT studies showed mixed pattern of response. Synchronous use of PRRNT and radiosensitizing chemotherapy seems safe and feasible in high risk MCC patients, however, further prospective studies and clinical trials are warranted to provide reliable evidence of possible pitfalls and effectiveness of PRRNT and 68Ga-somatostatin-receptor PET/CT in the management of MCC.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. THERANOSTICS Center for Molecular Radiotherapy and Molecular Imaging, ENETS Center of Excellence, Zentralklinik Bad Berka GmbH, 99437, Bad Berka, Germany

    Ali Salavati, Vikas Prasad & Richard Paul Baum

  2. Department of Oncology, Zentralklinik Bad Berka, Bad Berka, Germany

    Claus-Peter Schneider

  3. Department of Dermatology, Center for Skin Cancer, Helios Klinikum, Erfurt, Germany

    Rudolf Herbst

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  1. Ali Salavati
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  2. Vikas Prasad
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  3. Claus-Peter Schneider
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  4. Rudolf Herbst
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  5. Richard Paul Baum
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Correspondence to Richard Paul Baum.

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Salavati, A., Prasad, V., Schneider, CP. et al. Peptide receptor radionuclide therapy of Merkel cell carcinoma using 177lutetium-labeled somatostatin analogs in combination with radiosensitizing chemotherapy: a potential novel treatment based on molecular pathology. Ann Nucl Med 26, 365–369 (2012). https://doi.org/10.1007/s12149-012-0578-3

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  • DOI: https://doi.org/10.1007/s12149-012-0578-3

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