Myeloid neoplasms after chemotherapy and PRRT: myth and reality
- Lisa Bodei1,2,*⇑,
- Irvin M Modlin2,3,
- Markus Luster4,*,
- Flavio Forrer5,*,
- Marta Cremonesi6,
- Rodney J Hicks7,
- Samer Ezziddin8,*,
- Mark Kidd9 and
- Arturo Chiti10,*
- 1Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- 2LuGenIum Consortium for Independent Research, Milan, Rotterdam, Bad Berka, London
- 3Emeritus Professor Gastroenterological Surgery, Yale University, School of Medicine, New Haven, Connecticut, USA
- 4Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
- 5Nuclear Medicine, Cantonal Hospital, St. Gallen, Switzerland
- 6Division of Health Physics, European Institute of Oncology, Milan, Italy
- 7Centre for Cancer Imaging, The Peter MacCallum Cancer Centre, St Andrew’s Place, East Melbourne, Australia
- 8Department of Nuclear Medicine, Saarland University Hospital, Homburg, Saarland, Germany
- 9Wren Laboratories, Branford, Connecticut, USA
- 10Humanitas University, Milan, Italy
- Correspondence should be addressed to L Bodei; Email: bodeil{at}mskcc.org
Abstract
Peptide receptor radionuclide therapy (PRRT) with 90Y-octreotide or 177Lu-octreotate is an effective treatment for inoperable or metastatic neuroendocrine tumors (NETs), particularly well-differentiated gastroenteropancreatic or bronchopulmonary NETs. PRRT is generally extremely well tolerated, with modest toxicity to target organs, kidney and bone marrow. Nevertheless, a priori concerns regarding long-term effects lead clinicians such as Brieau and coworkers, in this ERC issue, to ascribe to the combination of alkylating agents and PRRT the apparently high occurrence (n=4) of myeloproliferative events (therapy-related myeloid neoplasms (t-MNs)) in a small cohort of 20 progressive, advanced digestive NETs treated with PRRT after chemotherapy. Anecdotal reports of myelotoxic events should be placed in the correct perspective of larger series, where the reported incidence of these events is ~2%, with the aim of promoting a balanced awareness of the issue and unbiased and reasonable overall conclusions. For a comprehensive definition of the issue, we provide an evaluation of the occurrence of t-MN in patients treated with various myelotoxic treatments.
- Received 20 June 2016
- Accepted 27 June 2016
- Made available online as an Accepted Preprint 1 August 2016
- © 2016 Society for Endocrinology
