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177 Lu-Dota-NOCate & 177 Lu-Dota-Gastrin in Metastatic Medullary Thyroid Cancer. Clinic of Endocrinology, Inst. of Nuclear Medicine, University Hospital, Basel, CH For Questions contact: Beat Müller , happymiller@bigfoot.com Martin A. Walter , m.a.walter@gmx.net. Medullary Thyroid Cancer.
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177Lu-Dota-NOCate&177Lu-Dota-Gastrinin Metastatic Medullary Thyroid Cancer Clinic of Endocrinology, Inst. of Nuclear Medicine, University Hospital, Basel, CH For Questions contact: Beat Müller, happymiller@bigfoot.com Martin A. Walter, m.a.walter@gmx.net
Medullary Thyroid Cancer Treatment Options: • Surgery (first line) • To date no effective systemic treatment option • Radiation Therapy is not well defined • Treatment options with different Radiopeptides are currently evaluated
Aim To assess the value of 177Lu-Dota-NOCate and 177Lu-Dota-Gastrin in Imaging and Treatment of Metastatic Medullary Thyroid Cancer Ethically Approved (EKBB)
Signal 177Lu Target Somatostatin/ CCK2-Receptor Ligand Somatostatin/ Gastrin-Analogs Radiopeptides
Metastases Tumor Application Distribution Accumulation „Magic Bullet“ Approach
Receptor Profile (MTC) EB Forssell-Aronsson. J Nucl Med2000;41:636–642
Pilot-Patient (Dota-NOC-ATE) Specific Tumor Uptake (LN-metastesis) p9581 ♂, 63y Metastised MTC
Patients Patients with progressive MTC Exclusion criteria: • Karnofsky Performance Status < 50% • Refusion of a 1-year contraception • Pregnancy • Breast-feeding • Age<18
Diagnostic Scintigraphy • Scintigraphy + Dosimetry (first compound, outpatient, 2d) • Scintigraphy + Dosimetry (second compound, outpatient, 2d) 2 weeks later • Significant Accumulation + Favorable Biodistribution → Treatment
Treatment • Inpatient • 3 Days • Day 1: Injection of Radiopeptide + Amino Acid Infusion (Kidney Protection) • Day 2: Imaging • Day 3: Release of Patient