AUTHOR=Okwundu Nwanneka , Weil Christopher R. , Soares Heloisa P. , Fine Gabriel C. , Cannon Donald M. 

TITLE=Case report: Efficacy of lutetium-177 oxodotreotide for neuroendocrine tumor with central nervous system metastases

JOURNAL=Frontiers in Nuclear Medicine

VOLUME=Volume 3 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/nuclear-medicine/articles/10.3389/fnume.2023.1074948

DOI=10.3389/fnume.2023.1074948

ISSN=2673-8880

ABSTRACT=Neuroendocrine tumors (NETs) rarely metastasize to the brain. However when they occur, NET brain metastases are associated with a poor prognosis. Due to the low incidence, NET brain metastases are poorly studied, with little data to guide a consensus for management. Prior reports have documented treatment with chemotherapy, resection, whole brain radiation therapy, and stereotactic radiosurgery, all with low rates of survival. We present a case of a patient with type 3 well differentiated gastric NET with widespread metastatic disease, including central nervous system lesions in the pineal gland and left cerebellopontine angle (CPA), which were avid on 68Ga-dotatate positron emission tomography. The patient received four doses of 200 mCi (7.4 GBq) Lutetium-177 oxodotreotide (177Lu-dotatate) administered every eight weeks over the course of six months. The treatments provided local control of the pineal and CPA lesions for 23 months until the development of diffuse leptomeningeal progression that necessitated further therapies. 177Lu-dotatate may be a viable treatment for local control of NET brain metastases. More studies are needed to validate its efficacy in this clinical scenario.