The efficacy of 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) in patients with metastatic neuroendocrine tumours: a systematic review and meta-analysis

Purpose To evaluate the efficacy of Lu-177-DOTA0-Tyr3-octreotate (Lu-177-DOTATATE) radionuclide therapy in patients with inoperable or metastatic neuroendocrine tumours (NETs), (PROSPERO ID CRD42019130755). Methods All published clinical studies of NETs treated with Lu-177-DOTATATE were identified based on systematic searches in the PubMed, EMBASE, Cochrane Library, Web of Science and ClinicalTrials.gov databases up to January 2019. Among these studies, only the reports evaluated with the "Response Evaluation Criteria in Solid Tumours (RECIST)" or "Southwest Oncology Group (SWOG)" criteria or both were included. We analysed the disease response rate (DRR) and disease control rate (DCR) of each group to evaluate the efficacy of Lu-177-DOTATATE. Results Fifteen studies were selected from 715 references. The pooled effect in the RECIST group (13 studies) was 27.58% (95% confidence interval (CI) 21.03-35.27%) for the DRR and 79.14% (95% CI 75.83-82.1%) for the DCR. In the SWOG criteria group (7 studies), the pooled effect was 20.59% (95% CI 10.89-35.51%) for the DRR and 78.28% (95% CI 74.39-81.72%) for the DCR. Therefore, the RECIST and SWOG groups showed similar DRRs and DCRs after(177)Lu-DOTATATE treatment, indicating that Lu-177-DOTATATE treatment has excellent efficacy with a control rate of approximately 78-79%. Moreover, adverse effects of Lu-177-DOTATATE were minimal, including fatigue, nausea, vomiting and hormonal disorders. Conclusions For patients with inoperable or metastatic NETs, Lu-177-DOTATATE is an effective treatment with minimal side effects.