Improvement of Laboratory Hepatic Parameters After Treatment With 177Lu-DOTATATE

Abstract

Purpose Well-differentiated neuroendocrine neoplasms (NETs) overexpress the somatostatin receptor, which is the target for the peptide receptor radionuclide therapy (PRRT). NETs have a slow growth rate and can metastasize to liver, bone, and lungs. In NETs patients, liver metastasis is an important prognostic marker because liver failure is one of the most common causes of death in this population. In this regard, we aimed to describe the changes in laboratorial parameters in patients submitted to PRRT with 177Lu-DOTATATE, focusing on hepatic parameters. Patients and Methods One hundred ten patients treated with 1 to 4 cycles of 7.4 GBq (200 mCi) of 177Lu-DOTATATE from January 2011 to December 2021 were analyzed in this retrospective observational single-center study. Patients were submitted to blood tests before and after each cycle of PRRT. Laboratory measurements were collected to assess liver function, cholestasis, kidney, and bone marrow function. Results In the general population (n = 110), ALP (P = 0.013) and GGT (P < 0.001) showed a statistically significant reduction. Patients with high liver disease volume showed a statistically significant reduction in ALT (P = 0.016), whereas patients with low liver disease volume showed a statistically significant reduction in GGT (P = 0.013). All parameters for bone marrow function showed a statistically significant decrease in all population subsets. Conclusions Patients treated with 177Lu-DOTATATE showed a significant improvement in liver function and cholestasis parameters, and a consistent decrease in bone marrow function, even in the presence of advanced liver disease.