177177Lu-Dota-NOCateLu-Dota-NOCate &&

177177Lu-Dota-GastrinLu-Dota-Gastrin in in

Metastatic Medullary Thyroid CancerMetastatic 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 of177Lu-Dota-NOCate and 177Lu-Dota-Gastrin

in Imaging and Treatment of

Metastatic Medullary Thyroid Cancer

Ethically Approved (EKBB)

Radiopeptides

Target

Somatostatin/

CCK2-Receptor

Ligand

Somatostatin/

Gastrin-Analogs

Signal

177Lu

„Magic Bullet“ Approach

Application Distribution Accumulation

Tumor

Metastases

Affinity Profile (Dota-NOC-ATE)

Receptor Profile (MTC)

EB Forssell-Aronsson. J Nucl Med 2000;41:636–642

Pilot-Patient (Dota-NOC-ATE)

SpecificTumor Uptake(LN-metastesis)

p9581♂, 63yMetastised 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