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A Patient With Metastatic Sarcoma was Successfully Treated With Radiolabeled Somatostatin Analogs

View Article: PubMed Central - PubMed

ABSTRACT

We present a sarcoma patient with a tumor reduction of more than 50% in lung metastasis after 2 single courses of the investigational medical product Lutathera (177Lu-DOTA0-Tyr3-octreotate). She was resistant to more than 6 lines of therapy including all the available active drugs in soft tissue sarcomas. The high expression of somatostatin receptors was shown by microarrays and Octreoscan. The overall duration of response exceeded 1 year.

No MeSH data available.


Related in: MedlinePlus

A 36-year-old woman with a diagnosis of a left popliteal synovial sarcoma treated with surgery and chemotherapy (adryamicin/ifosfamide). A local recurrence required additional surgery followed by chemoradiotherapy (70 Gy plus ifosfamide). She had a disease-free interval of 4 years until lung metastasis was detected. Between October 2007 and May 2012, she was treated with several drug combinations (in total, she had been resistant to >6 lines of therapy including all the available active drugs in soft tissue sarcomas) and operated by thoracotomy in 3 stages. Pazopanib treatment was initiated in November 2012 and then interrupted because of hemoptysis. She was referred to our institution in February 2013 presenting extreme weight loss and a performance status of 2. The most recent scan showed lung metastasis in more than 50% of the right side of the thorax, with large pleural disease and mediastinum involvement. Traqueal compression at carina level was present. A computed tomography–guided needle biopsy from a lung metastatic lesion was performed for an expression microarray. A highly significant expression of the somatostatin receptor 2 (SSTR2) gene (in excess of 10-fold) and to a lesser extent SSTR5 (>5-fold) as compared with the normal control tissue was apparent in the normalized microarray data. There are references in literature identifying SSTR in more than 80% of the soft tissue tumors analyzed by reverse transcriptase–polymerase chain reaction,1,2 as well as positive uptake in molecular imaging.3,4 Figure 1 shows the high uptake in the right hemithorax in the Octreoscan confirming the potential indication for somatostatin analog–based treatments. She began lanreotide 30 mg intramuscularly every 2 to 3 weeks until May 31, 2013, reaching disease stabilization.
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FU1: A 36-year-old woman with a diagnosis of a left popliteal synovial sarcoma treated with surgery and chemotherapy (adryamicin/ifosfamide). A local recurrence required additional surgery followed by chemoradiotherapy (70 Gy plus ifosfamide). She had a disease-free interval of 4 years until lung metastasis was detected. Between October 2007 and May 2012, she was treated with several drug combinations (in total, she had been resistant to >6 lines of therapy including all the available active drugs in soft tissue sarcomas) and operated by thoracotomy in 3 stages. Pazopanib treatment was initiated in November 2012 and then interrupted because of hemoptysis. She was referred to our institution in February 2013 presenting extreme weight loss and a performance status of 2. The most recent scan showed lung metastasis in more than 50% of the right side of the thorax, with large pleural disease and mediastinum involvement. Traqueal compression at carina level was present. A computed tomography–guided needle biopsy from a lung metastatic lesion was performed for an expression microarray. A highly significant expression of the somatostatin receptor 2 (SSTR2) gene (in excess of 10-fold) and to a lesser extent SSTR5 (>5-fold) as compared with the normal control tissue was apparent in the normalized microarray data. There are references in literature identifying SSTR in more than 80% of the soft tissue tumors analyzed by reverse transcriptase–polymerase chain reaction,1,2 as well as positive uptake in molecular imaging.3,4 Figure 1 shows the high uptake in the right hemithorax in the Octreoscan confirming the potential indication for somatostatin analog–based treatments. She began lanreotide 30 mg intramuscularly every 2 to 3 weeks until May 31, 2013, reaching disease stabilization.


A Patient With Metastatic Sarcoma was Successfully Treated With Radiolabeled Somatostatin Analogs
A 36-year-old woman with a diagnosis of a left popliteal synovial sarcoma treated with surgery and chemotherapy (adryamicin/ifosfamide). A local recurrence required additional surgery followed by chemoradiotherapy (70 Gy plus ifosfamide). She had a disease-free interval of 4 years until lung metastasis was detected. Between October 2007 and May 2012, she was treated with several drug combinations (in total, she had been resistant to >6 lines of therapy including all the available active drugs in soft tissue sarcomas) and operated by thoracotomy in 3 stages. Pazopanib treatment was initiated in November 2012 and then interrupted because of hemoptysis. She was referred to our institution in February 2013 presenting extreme weight loss and a performance status of 2. The most recent scan showed lung metastasis in more than 50% of the right side of the thorax, with large pleural disease and mediastinum involvement. Traqueal compression at carina level was present. A computed tomography–guided needle biopsy from a lung metastatic lesion was performed for an expression microarray. A highly significant expression of the somatostatin receptor 2 (SSTR2) gene (in excess of 10-fold) and to a lesser extent SSTR5 (>5-fold) as compared with the normal control tissue was apparent in the normalized microarray data. There are references in literature identifying SSTR in more than 80% of the soft tissue tumors analyzed by reverse transcriptase–polymerase chain reaction,1,2 as well as positive uptake in molecular imaging.3,4 Figure 1 shows the high uptake in the right hemithorax in the Octreoscan confirming the potential indication for somatostatin analog–based treatments. She began lanreotide 30 mg intramuscularly every 2 to 3 weeks until May 31, 2013, reaching disease stabilization.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979627&req=5

FU1: A 36-year-old woman with a diagnosis of a left popliteal synovial sarcoma treated with surgery and chemotherapy (adryamicin/ifosfamide). A local recurrence required additional surgery followed by chemoradiotherapy (70 Gy plus ifosfamide). She had a disease-free interval of 4 years until lung metastasis was detected. Between October 2007 and May 2012, she was treated with several drug combinations (in total, she had been resistant to >6 lines of therapy including all the available active drugs in soft tissue sarcomas) and operated by thoracotomy in 3 stages. Pazopanib treatment was initiated in November 2012 and then interrupted because of hemoptysis. She was referred to our institution in February 2013 presenting extreme weight loss and a performance status of 2. The most recent scan showed lung metastasis in more than 50% of the right side of the thorax, with large pleural disease and mediastinum involvement. Traqueal compression at carina level was present. A computed tomography–guided needle biopsy from a lung metastatic lesion was performed for an expression microarray. A highly significant expression of the somatostatin receptor 2 (SSTR2) gene (in excess of 10-fold) and to a lesser extent SSTR5 (>5-fold) as compared with the normal control tissue was apparent in the normalized microarray data. There are references in literature identifying SSTR in more than 80% of the soft tissue tumors analyzed by reverse transcriptase–polymerase chain reaction,1,2 as well as positive uptake in molecular imaging.3,4 Figure 1 shows the high uptake in the right hemithorax in the Octreoscan confirming the potential indication for somatostatin analog–based treatments. She began lanreotide 30 mg intramuscularly every 2 to 3 weeks until May 31, 2013, reaching disease stabilization.

View Article: PubMed Central - PubMed

ABSTRACT

We present a sarcoma patient with a tumor reduction of more than 50% in lung metastasis after 2 single courses of the investigational medical product Lutathera (177Lu-DOTA0-Tyr3-octreotate). She was resistant to more than 6 lines of therapy including all the available active drugs in soft tissue sarcomas. The high expression of somatostatin receptors was shown by microarrays and Octreoscan. The overall duration of response exceeded 1 year.

No MeSH data available.


Related in: MedlinePlus