Authors: Taymeyah E. Al-Toubah, Eleonora Pelle, Jonathan R. Strosberg
Published: 2022-01-19
DOI: 10.1200/jco.2022.40.4_suppl.513
Source: Full article
513 Background: The treatment landscape for neuroendocrine tumors includes alkylating-agent chemotherapy and peptide receptor radiotherapy (PRRT) with 177Lu-Dotatate. The risk of MDS/AML associated with 177Lu-Dotatate is approximately 2-3%. Several small prior studies have suggested substantially higher rates of MDS/AML (approximately 10%) in patients who have also received alkylating agent chemotherapy with streptozocin or temozolomide, either combined with PRRT or sequentially. Methods: Retrospective study of all patients with advanced NENs treated at the Moffitt Cancer Center between 1/2008 and 9/2019 who received treatment with CAPTEM. Results: 462 patients received treatment with CAPTEM, among whom 49 received also received PRRT. Median follow-up was x months. 4 patients developed MDS/AML, all of whom had also received both CAPTEM and PRRT. None of the patients who received CAPTEM chemotherapy without PRRT developed a long-term hematological malignancy. Conclusions: 8% of patients who received both CAPTEM and PRRT developed MDS or AML, a risk that is higher than that associated with PRRT alone. This cumulative risk needs to be considered when sequencing treatments in NETs.