# Results and adverse events of personalised peptide receptor radionuclide therapy in 1048 patients with neuroendocrine neoplasms

Source: https://nuclide.cc/key-papers/paper-baum-prrt-1048-patients-oncotarget-2018/  
Nuclide record `paper-baum-prrt-1048-patients-oncotarget-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

The largest single-centre report of a radioactive treatment for neuroendocrine tumours, from over a thousand patients treated across a decade at one German hospital, showing typical survival times and how often serious side effects such as blood cancers occurred.

## Summary

This retrospective single-centre analysis from Zentralklinik Bad Berka, Germany, reports outcomes for 1048 patients with neuroendocrine neoplasms treated with personalised peptide receptor radionuclide therapy (PRRT) using 90Y- and/or 177Lu-labelled somatostatin analogues between 2004 and 2014, drawn from 2294 patients screened by 68Ga-SSTR PET/CT. Radionuclide, dose and cycle number were individualised to tumour and organ dosimetry rather than fixed, reflecting the Bad Berka group's long-standing personalised-dosimetry approach to PRRT, predating the fixed four-cycle regimen later used in NETTER-1.

Median overall survival across all patients was 51 months (95% CI 47.0-54.9), varying significantly by radionuclide used, tumour grade, prior therapies and tumour origin (for example, gastrinoma and glucagonoma patients had median survival of 66 and 127 months respectively; insulinoma patients 32 months). Median progression-free survival (by 68Ga-SSTR PET/CT with EORTC criteria) was 19 months. Myelodysplastic syndrome or leukaemia developed in 22 patients (2.1%), and five patients required haemodialysis after treatment; other serious adverse events were rare.

As one of the largest published PRRT cohorts, and predating the randomised NETTER-1 trial, this paper was widely cited as real-world evidence for PRRT's long-term safety and effectiveness, and its dosimetry-personalised approach is a touchstone for the ongoing debate about fixed-activity versus dosimetry-guided PRRT dosing.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: neuroendocrine tumours; PRRT; real-world evidence
- Journal: Oncotarget
- Year: 2018
- DOI: 10.18632/oncotarget.24524
- Authors: Baum RP, Kulkarni HR, Singh A, Kaemmerer D, Mueller D, et al.
- Findings: Median overall survival across all 1048 patients: 51 months (95% CI 47.0-54.9), varying by radionuclide, tumour grade, prior therapies and site of origin.; Median progression-free survival by 68Ga-SSTR PET/CT: 19 months overall.; Myelodysplastic syndrome or leukaemia developed in 22 of 1048 patients (2.1%); 5 patients required haemodialysis after treatment.; Survival varied widely by tumour subtype: gastrinoma 66 months and glucagonoma 127 months median OS, versus insulinoma 32 months.
- What it means: In the largest reported group of neuroendocrine tumour patients treated with individually dosed radioactive peptide therapy, most people lived several years after treatment, and serious long-term harms such as blood cancers were uncommon but real, occurring in about 1 in 50 patients.
- Caveats: Retrospective, single-centre, uncontrolled cohort - there is no comparator arm, so the survival figures cannot be attributed to PRRT alone.; Radionuclide choice, dose and cycle number were personalised per patient rather than fixed, so results may not generalise directly to fixed-activity regimens such as the one used in NETTER-1 or Lutathera's approved label.; Long recruitment period (2004-2014) spans changes in imaging, patient selection and supportive care that could affect outcomes over time.

## Sources

- PMC: full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC5908296/
- PubMed record: https://pubmed.ncbi.nlm.nih.gov/29682217/

## Connected records

- technologies: [Peptide receptor radionuclide therapy (PRRT)](https://nuclide.cc/technologies/prrt/), [Radioligand dosimetry](https://nuclide.cc/technologies/radioligand-dosimetry/)
- drugs: [Lutetium-177 dotatate](https://nuclide.cc/drugs/lutathera/)
- indications: [Neuroendocrine tumours](https://nuclide.cc/indications/neuroendocrine/)
- people: [Richard P. Baum](https://nuclide.cc/people/richard-baum/)
- key papers: [NETTER-1: 177Lu-Dotatate for midgut neuroendocrine tumours progressing on octreotide](https://nuclide.cc/key-papers/paper-netter-1-nejm-2017/)
- isotopes: [Gallium-68](https://nuclide.cc/isotopes/ga-68/), [Lutetium-177](https://nuclide.cc/isotopes/lu-177/), [Yttrium-90](https://nuclide.cc/isotopes/y-90/)

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