Searchable abstracts of presentations at key conferences in endocrinology
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NANETS 2023

Abstracts

Clinical – Nuclear Medicine/Interventional Radiology/Imaging

ea0098c18 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

[68Ga] DOTA-TATE (NETSpot) PET/CT Imaging of Pulmonary Neuroendocrine Tumors

Grage MD Rolf , MD Matt Dudgeon , Sharma Akash , Parent Ephraim

Background: Neuroendocrine tumors (NETs), also known as carcinoid, comprise a heterogeneous group of malignancies that arise from neuroendocrine cells throughout the body, most commonly originating from the gastrointestinal tract and lungs. Lung NETs originate from pulmonary neuroendocrine cells (PNECs) that occur as individual cells or small clusters, accounting for approximately 25% of primary lung neoplasms. Lungs NETs can be classified into four subtypes: well-differentiat...

ea0098c19 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

The Impact of Post-Treatment Imaging in Peptide Receptor Radionuclide Therapy

Yadav, MD Surekha , Lawhn-Heath, MD Courtney , Lindsay, NP Sheila , Mirro, RN Rebecca , Bergsland, MD Emily K. , A Hope, MD Thomas

Background: A small portion (11%) of radioactive decay of 177Lu involves the emission of gamma photons, allowing for post-treatment imaging. Despite this capability, most centers do not routinely conduct post-treatment imaging. It is not well recognized that qualitative findings from post-PRRT imaging can influence clinical management. The aim of this study was to evaluate the rate of change in management from post treatment imaging.Methods: 100 patients...

ea0098c20 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Yttrium 90 transarterial radioembolization of neuroendocrine liver metastasis

Yuan Gavin , Petre Elena , Ziv Etay , Moussa Amgad , Gonzalez Aguirre Adrian , Latzman Jonathan , Reidy Diane , Raj Nitya , Alexander Erica

Background: To determine the safety and efficacy of Yttrium 90 (Y90) transarterial radioembolizations (TARE) for neuroendocrine liver metastasis (NLM) and elucidate factors that affect outcomes.Methods: Retrospective analysis of 39 patients with NLM in a single center who underwent 65 Y90 TAREs with glass or resin microspheres between April 2012 and December 2022. There were 17 male and 22 female with a mean age at time of treatment of 65.5 years (SD &pm...

ea0098c21 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Ratio of total uptake volume on DOTATATE vs FDG PET as a predictive marker of treatment efficacy of Lu-177-DOTATATE in metastatic pheochromocytoma

Lin Frank I. , Del Rivero Jaydira , Carrasquillo Jorge , Shamis Inna , Zou Joy , Turkbey Baris , Jha Abhishek , Klubo Joanna , Adler Steve , Mena Esther , Lindenberg Liza , Chen Clara , Herscovitch Peter , Millo Corina , Pacak Karel

Background: Pheochromocytoma/Paraganglioma (PPGL) are rare neuroendocrine tumors that expresses somatostatin receptors (SSTR) and can be treated with radiolabeled somatostatin analogues such as Lu-177-DOTATATE. Ga-68-DOTATATE PET scans show the distribution and density of SSTR+ tumors, and F-18-FDG PET scans show hypermetabolism in lesions. Total uptake volumes (TUV) for each respective scan can be obtained consistently and semi-automatically using standardized workflow in ima...

ea0098c22 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Phase 2 trial of lu-177-DOTATATE in metastatic or inoperable pheochromocytoma/paraganglioma: interim analysis results

Lin Frank I. , Del Rivero Jaydira , Carrasquillo Jorge , Shamis Inna , Zou Joy , Turkbey Baris , Jha Abhishek , Klubo Joanna , Teng Ya-ting , Mena Esther , Lindenberg Liza , Chen Clara , Herscovitch Peter , Millo Corina , Pacak Karel

Background: Pheochromocytoma/Paraganglioma (PPGL) are rare neuroendocrine tumors that expresses somatostatin receptors (SSTR) and can be treated with radiolabeled somatostatin analogues such as Lu-177-DOTATATE. This study is the first prospective study to examine the safety and efficacy of Lu-177-DOTATATE in the treatment of metastatic or inoperable PPGL in a phase 2 clinical trial setting, and results from a planned interim analysis are presented.Method...

ea0098c23 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Phase 1/2 study of Lu-177-DOTATATE in combination with olaparib in metastatic or inoperable GI neuroendocrine tumors - first results

Lin Frank I. , Del Rivero Jaydira , Carrasquillo Jorge , Shamis Inna , Zou Joy , Turkbey Baris , Klubo Joanna , Mena Esther , Lindenberg Liza , Chen Clara , Herscovitch Peter , Millo Corina , Pacak Karel

Background: GI neuroendocrine tumors express somatostatin (SSTR) receptors, and the radioloabeled SSTR analog Lu-177-DOTATATE is an FDA-approved systemic treatment for those with metastatic disease. Olaparib is a poly (ADP-ribose) polymerase inhibitor (PARPi) which inhibits cells from repairing damaged DNA, especially single-stranded DNA breaks caused by beta particle emissions from the radioactive decay of Lu-177. We report the first results of a phase 1/2 study evaluating th...

ea0098c24 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

68Ga-DOTATATE/18F-FDG dual PET: Utility of the NETPET score in management of G2-3 WD NENs

Nunez Jose E. , Chan David L. , Kulanthaivelu Roshini , Murad Vanessa , Singh Simron , Metser Ur

Background: The clinical heterogeneity of G2 and G3 well-differentiated GEP-NENs make it difficult to choose an effective treatment plan, highlighting the need of molecular imaging in the treatment of NETs patients. It has been suggested that a dual-tracer 68Ga-DOTATATE/18F-FDG grading scoring system could be a useful imaging biomarker. This pilot study aims to validate the prior observation from Chan et al. (BJC 2022) of variability in NETPET scores in G2-G3 WD GEP NENs and a...

ea0098c25 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

A pilot study of pembrolizumab and peptide receptor radionuclide therapy for patients with metastatic well-differentiated neuroendocrine tumors

Fidelman MD Nicholas , Keenan MD, PhD Bridget P. , Oh MD David Y. , Fong MD Lawrence , Chan BS Kira , Zhang PhD Li , Bergsland MD Emily K. , Hope MD Thomas A.

Background: Expected progression free survival (PFS) for patients with grade 3 well-differentiated neuroendocrine tumors (WD NET) treated with peptide receptor radionuclide therapy (PRRT) is approximately 9 months, and objective response rate (ORR) is 35%. Response rate to single agent immune checkpoint inhibitors (ICI) for patients with G1-3 NET is <15%. Delivery of targeted radiation using PRRT may potentiate the anti-tumor immune response. The purpose of this study is t...

ea0098c26 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

A pilot study of pembrolizumab and embolization or 90Y radioembolization for patients with metastatic well-differentiated neuroendocrine tumors

Fidelman MD Nicholas , Fong MD Lawrence , Zhang PhD Li , Bergsland MD Emily K.

Background: Well-differentiated neuroendocrine tumors (WD-NET) have a relatively low tumor mutation burden and do not commonly express the programmed death ligand 1 (PD-L1), characteristics which may limit the anti-tumor activity of PD-L1 inhibitors in this disease. Response rate to single agent immune checkpoint inhibitors (ICI) for patients with G1-3 NET is <15%. The intensity of anti-tumor immune response may be enhanced by addition of liver-directed therapy (LDT), such...

ea0098c27 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

ETCTN 10388: A first in human Phase I Trial of Triapine and Lutetium Lu 177 DOTATATE in Well-Differentiated Somatostatin Receptor-Positive Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs)

Chauhan Aman , Arnold Susanne , Kolesar Jill , Carson William , Weiss Heidi , Yan Donglin , El Khouli Riham , Khurana Aman , Beumer Jan , Soares Heloisa , Mulcahy Mary , Halfdanarson Thorvardur , Li Daneng , Jacene Heather , Ivy Percy , Kohn Elise , Wright John , Rubinstein Larry , Kunos Charles , Anthony Lowell , Konda Bhavana

Background: Radiation is a potent inducer of DNA double-strand breaks, and ribonucleotide reductase (RNR) is the rate-limiting enzyme in the synthesis and repair of DNA, making RNR-targeted therapy a rationale therapeutic strategy for radiosensitization. ETCTN 10388 (NCT04234568) evaluated safety and efficacy of the combination of lutetium 177 DOTATATE, a beta-emitting radionuclide in combination with triapine, a ribonucleotide reductase (RNR) inhibitor. <p class="abstext"...

ea0098c28 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

ETCTN 10450: A phase I trial of peposertib and lutetium 177 DOTATATE in well-differentiated somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

Chauhan Aman , Kolesar Jill , Yan Donglin , Li Daneng , Khurana Aman , Edgar Carson William , Arnold Susanne M. , Gore Steven , Rubinstein Larry , Kohn Elise C. , Percy Ivy S. , Xiao Ying , Dewaraja Yuni , Soares Heloisa P. , Hendrik Beumer Jan , Konda Bhavana , Sukrithan Vineeth , Brian Anthony Lowell

Background: Radiolabeled somatostatin analogs provide a means of delivering targeted radiation with a high therapeutic index to NETs that express somatostatin receptors (SSTRs). We hypothesize that the addition of an effective radiation sensitizer could help improve the antitumor activity of Lutathera. Radiation is a potent inducer of DNA damage. The primary repair mechanism of radiation-induced double-stranded breaks (DSBs) is the nonhomologous end-joining (NHEJ) pathway, in ...

ea0098c29 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Small bowel ischemia in patients with midgut neuroendocrine tumors after treatment with 177Lutetium-Dotatate

Pelle, MD Eleonora , Al-Toubah, MPH Taymeyah , El-Haddad, MD Ghassan , Strosberg, MD Jonathan

Background: 177Lutetium (Lu)-Dotatate is a safe and well tolerated treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-Dotatate treated patients.Methods:...

ea0098c30 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Novel alternate (Alt) response criteria for early outcome prediction in pancreatic (P) neuroendocrine tumors (NETs): utilizing banked imaging and radiomics

Lareef Ishara , Vijayvergia Namrata , Handorf Elizabeth , Kunz Pamela L. , Alkim Emil , Burke Lauren M. , Catalano Paul , Graham Noah , Levin Laura , Li Weier , Meeker Caitlin , Rubin Daniel , Sridharan Anush , O'Dwyer Peter J. , Wong Terence Z. , Anaokar Jordan

Background: Evaluating treatment (Tx) Response in NETs using CT/MRI scans can be difficult. Previous studies, including the E2211, have shown improved progression-free survival (PFS) but no significant difference in Rp as measured by RECIST 1.1 (R1.1) criteria. Therefore, it is difficult to determine Tx effectiveness with short-term imaging, further complicated by differences in imaging protocols and inter-reader variability. Incorporating tumor density, using smaller threshol...

ea0098c31 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

High-specific-activity iodine-131-meta-iodo-benzylguanidine for the treatment of advanced pheochromocytoma and paraganglioma: a real-world study

Al-Ward Ruaa , Balderrama Brondan Vania , Sawani Sahar , Bassett Roland , Xu Guofan , Waguespack Steven G. , Varghese Jeena , Amir Habra Mouhammed , Lu Yang , Jimenez Camilo

Background: Metastatic pheochromocytomas and paragangliomas are rare neuroendocrine tumors with limited treatment options. We studied the efficacy and safety of off-label High-Specific-Activity I-131-meta-iodobenzylguanidine (HSA-I-131-MIBG) in routine clinical practice. Methods: This is a retrospective cohort study. The primary endpoint is objective response rate (ORR) as per RECIST v1.1. Secondary endpoints are blood pressure control, safety, overall a...

ea0098c32 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Myelodysplasia and leukemia instances after PRRT: Experience from a tertiary institution

Trikalinos, MD Nikolaos , De La Iglesia, MD Michael , Prasad MD, PhD Vikas , Amin, MD Manik , Winter, BSN, RN Kyle , Schutte MSN, FNP-C, AOCNP Justin , Kim, MD Hyun

Background: Peptide receptor radionuclide therapy (PRRT) was introduced in 2018 as one of the major advances in treatment of patients with neuroendocrine neoplasms (NENs). Initial results from the NETTER-1 trial suggested a very low percentage of secondary hematological malignancies, including myelodysplastic syndrome (MDS) and acute myelogenous leukemia (AML). We sought to confirm that data in a large institutional database. Methods: Under an institutio...

ea0098c33 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

DOTATATE PET/CT imaging in prostate cancer: incidental observations and potential future implications

E Salem MD, PhD Ahmed , Soares MD Heloisa P. , Fine MD Gabriel C , Morton MD. Kathryn A

Background: Hormonally-refractory, lethal forms of PCa may express neuroendocrine features, including PCa with neuroendocrine differentiation (NEDPCa) and treatment emergent small cell neuroendocrine PCa (tSCNC). We hypothesize that some lethal metastatic PCa may show higher expression of SSTR than of PSMA and that a dual imaging approach with PET radiopharmaceuticals targeting these moieties will enable informed selection of patients for the future corresponding therapeutic r...

ea0098c34 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Comparative assessment of 111in-octreotide scintigraphy, 68GA-DOTATOC PET/CT and 18F-FDG PET/CT in the staging and management of neuroendocrine tumors (NETs)

Zaidi Ali , Chia Brendan , Zhou Marilyn , Ladua Gale , Ravi Pavithraa , Bloise Ingrid , Harsini Sara , Wilson Don , Benard Francois , Martineau Patrick , Loree Jonathan M

Background: Accurate imaging is essential for NETs. 111In-octreotide scintigraphy, 68Ga-DOTATOC PET/CT and 18F-FDG PET/CT are the most commonly used modalities. This study compared the three modalities to ascertain the added value of newer functional imaging approaches.Methods: A retrospective review was performed on patients who underwent 68Ga-DOTATOC PET/CT and 18F-FDG PET/CT between 07/2018 and 03/2023 as part of a clinical trial at BC Cancer. Patient...

ea0098c35 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Institutional retrospective review of peptide receptor radionuclide therapy use in metastatic paragangliomas and pheochromocytomas

Lan Wong PA-C, Yee , MD, PhD. James Thomas

Background: Metastatic paragangliomas (PGL) and pheochromocytomas (PCC) are rare neuroendocrine diseases with an incidence of 2 to 8 people per million, a prevalence between 1:2500 and 1:6500 and a strong hereditary disposition. However, due to the rarity of the disease, there is relatively limited data on treatment options, including radionuclide therapy using radioisotope analogs of MIBG and dotatate. There are a few published small series on clinical benefits of treating PG...

ea0098c37 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Initial Experience Using 0.55T MRI for Detection of Liver Metastases in NET Patients

Remick Isabelle , Armstrong Hope Thomas , Ohliger Michael , William Hong Cheng , Yang Yang , Bergsland Emily , Lawhn Heath Courtney , Su Pan , Itriago-Leon Pedro

Background: 0.55T MRI is a new MRI technology offering increased patient accessibility with a wider bore (80cm) and reduced acoustic noise. We compared the sensitivity of liver metastases detection on gadoxetate-enhanced 0.55T MRI to 68Ga-DOTATATE PET/CT while evaluating patient experience.Methods: Nine patients with neuroendocrine liver metastases were imaged using gadoxetate-enhanced 0.55T MRI (MAGNETOM Free.Max, Siemens Healthineers, Erlang...

ea0098c38 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Are there any clinical factors associated with PRRT-refractoriness in NET patients?

Gupta Garima , Yadav Rina , Yan Donglin , Anthony Lowell , Ramirez Robert , Chauhan Aman

Background: Peptide receptor radionuclide therapy (PRRT) with Lutetium-177 DOTATATE (LUTATHERA) is an effective treatment option for somatostatin receptor (SSTR) positive metastatic gastroenteropancreatic neuroendocrine tumors (NETs) and has also demonstrated antitumor activity in SSTR positive NETs from other primary sites. While the median progression free survival (mPFS) is around 29 months, there is a subset of patients who are refractory to PRRT and demonstrate progressio...

ea0098c39 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Repeat peptide receptor radionuclide therapy in neuroendocrine neoplasms: a NET center of excellence experience

Grewal, MD Udhayvir Singh , Paschke, MD Alexander , Dillon, MD Joseph , Chandrasekharan, MD Chandrikha

Background: Lu177 DOTATATE Peptide Receptor Radionucleotide Therapy (PRRT) was FDA approved in the United States in 2018, however, the data for the safety and efficacy of repeat PRRT are almost exclusively from European centers. We present an updated experience with repeat PRRT in a cohort of US patients.Methods: We used our single-center longitudinal IRB approved neuroendocrine tumor (NET) registry to identify patients who had been previously treated wi...

ea0098c40 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Evaluation of long-term hepatic adverse events in patients receiving Peptide Receptor Radionuclide Therapy (PRRT) following BLAND embolization

Singh Grewal, MD Udhayvir , Paschke, MD Alexander , Dillon, MD Joseph , Chandrasekharan, MD Chandrikha

Background: Clinicians are concerned about increased hepatotoxicity in patients who received hepatic artery bland embolizations (TAE) and subsequent Peptide Receptor Radionuclide Therapy (PRRT). The body of literature describing the safety of PRRT following prior TAE is very limited. The purpose of this study is to evaluate the degree of long-term liver toxicity in patients who received PRRT in addition to previous hepatic embolizations for liver dominant disease.<p class=...

ea0098c41 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Spectrum of therapy-related clonal cytopenias and neoplasms after exposure to Lutetium-177-Dotatate

L Pritzl Stephanie , Kusne Yael , R Halfdanarson Thorvardur , Hobday Timothy , Bassam Sonbol Mohamad , Tuba Kendi Ayse , Mangaonkar Abhishek , Gangat Naseema , Shah Mithun , M Patnaik Mrinal

Background: Peptide receptor radionuclide therapy (PRRT) is a form of targeted systemic radiopharmaceutical therapy that has been approved for treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. Persistent hematologic dysfunction is a recognized potential long-term toxicity after PRRT, including the development of hematologic malignancies and persistent cytopenias. Therapy-related myeloid neoplasms (t-MN) are a well-recognized entity that ...

ea0098c42 | Clinical – Nuclear Medicine/Interventional Radiology/Imaging | NANETS2023

Treatment with Lutetium in a real-world setting: How does it affect patient experience and their time-toxicity?

Romina Luca Maria , Cecilia Vazquez Eliana , Waisberg Federico , Catani Greta , Oviedo Ana , Musumeci Martina , Rodriguez Andres , Bortz Marcos , Esteso Federico , Chacon Matias , Manuel Oconnor Juan , Racioppi Silvina

Background: Lutetitum-177 (Lu-DOTATE) is an approved treatment regimen for patients with advanced neuroendocrine tumors (NETs). Improving patient experience is one of main goals of a cancer treatment plan. "Time-toxicity" describes the period that patients spend in doing administrative or medical procedures, including medical visits, scans, lab analyses, emergency room admissions, drug applications and hospitalizations. Modern therapies are usually approved after an im...