WCLC 2025 - Posters & ePosters-P3.13.32 Real-World Outcomes of Patients With Bronchopulmonary Neuroendocrine Tumors Treated With Lutetium Lu 177 DOTATATE (Lutathera)

P3.13.32 Real-World Outcomes of Patients With Bronchopulmonary Neuroendocrine Tumors Treated With Lutetium Lu 177 DOTATATE (Lutathera)

Back to course

Pdf Summary

This retrospective study from Mayo Clinic evaluated real-world outcomes of Lutetium-177 (177Lu) DOTATATE (Lutathera) peptide receptor radionuclide therapy (PRRT) in 23 patients with metastatic bronchopulmonary neuroendocrine tumors (BPNETs) treated between 2014 and 2025. BPNETs represent 20-30% of neuroendocrine tumors, with management often individualized.<br /><br />Patients had a median age of 66 years; 61% were male. Metastases primarily involved liver (78%) and bone (61%). Tumors were classified per WHO 2017 criteria: 26% grade 1, 39% grade 2, and 26% grade 3, with 43% typical carcinoid and 57% atypical histology. Most patients had prior somatostatin analog therapy; other pre-PRRT treatments included chemotherapy (65%) and everolimus (43%). PRRT was administered typically as a third-line systemic treatment, median 4 cycles.<br /><br />Treatment response at 3 months post-PRRT showed a 17% partial response rate, 30% stable disease, 23% progressive disease, and no complete responses. The disease control rate was 48%. Median progression-free survival (PFS) was 10.8 months. PFS was longer in patients with a higher Krenning score (4 vs. 3, 14.7 vs. 7.3 months, p=0.042) but did not significantly differ by tumor histology. Median overall survival (OS) was 35.6 months.<br /><br />Adverse events were generally mild, with fatigue (35%), nausea (26%), and abdominal pain (22%) most common; no grade 3 or higher toxicities occurred, supporting tolerability.<br /><br />In conclusion, 177Lu DOTATATE PRRT in metastatic BPNETs shows moderate efficacy with a 48% disease control rate and median PFS about 11 months, and a favorable safety profile in routine clinical practice. The timing of PRRT use varied, most commonly as third-line therapy. These findings support 177Lu DOTATATE as a promising treatment option for metastatic BPNETs expressed somatostatin receptors, warranting further prospective evaluation.

Asset Subtitle

Giuseppe Maiocco

Meta Tag

Speaker Giuseppe Maiocco

Topic Small Cell Lung Cancer and Neuroendocrine Tumors

Keywords

Lutetium-177 DOTATATE

Peptide receptor radionuclide therapy

Metastatic bronchopulmonary neuroendocrine tumors

BPNETs

Real-world outcomes

Disease control rate

Progression-free survival

Overall survival

Somatostatin analog therapy

Adverse events