Peptide receptor radiotherapy re-treatment in patients with progressive neuroendocrine tumors: A systematic review and meta-analysis

BackgroundThis review and meta-analysis examined published evidence of peptide receptor radionuclide therapy (PRRT) re-treatment efficacy safety in patients with advanced neuroendocrine tumors (NETs).MethodsEmbase, MEDLINE, MEDLINE In-Progress, Cochrane CENTRAL were searched (database inception–present) to identify PRRT adults NETs previously treated 177Lu- and/or 90Y-PRRT. Progression-free survival (PFS), overall (OS), disease control rate (DCR) from time assessed. Data pooled using medians variance for time-to-event outcomes inverse-variance weighted proportions (Freeman-Tukey method) binary outcomes.ResultsOf 567 studies screened, 13 reported outcomes. In random-effects meta-analyses 177Lu-PRRT re-treatment, median PFS (N = 7 [414 patients]) was 12.52 months (95% CI 9.82–15.22) moderate heterogeneity across (I2 50.5%), OS 2 [194 26.78 18.73–34.83) moderate-to-high 57.5%), DCR 8 [347 71% 66–75) high 81.5%). similar either alone or combination Grade 3/4 adverse events occurred 5% 2–8) receiving 5 [271 few grade renal toxicities (0% [95% 0–1]). Pooled myelodysplastic syndrome acute myeloid leukemia incidence 0% 0–2).ConclusionRe-treatment provided encouraging a profile initial PRRT.