Glucagon-like peptide-1 versus somatostatin receptor targeting reveals 2 distinct forms of malignant insulinomas

Damian Wild, Emanuel Christ, Martyn E. Caplin, Tom R. Kurzawinski, Flavio Forrer, Michael Brändle, Jochen Seufert, Wolfgang A. Weber, Jamshed Bomanji, Aurel Perren, Peter J. Ell, Jean Claude Reubi

Research output: Contribution to journalArticlepeer-review

140 Scopus citations

Abstract

Glucagon-like peptide-1 (GLP-1) receptor imaging is superior to somatostatin receptor subtype 2 (sst2) imaging in localizing benign insulinomas. Here, the role of GLP-1 and sst2 receptor imaging in the management of malignant insulinoma patients was investigated. Methods: Eleven patients with malignant insulinoma were prospectively included. 111In-[Lys40(Ahx-diethylenetriaminepentaacetic acid [DTPA])NH2]-exendin-4 SPECT/CT, 68Ga- DOTATATE PET/CT, and in vitro receptor autoradiography were performed to assess the receptor status and to evaluate the detection rate. Results: GLP-1 receptor targeting was positive in 4 of 11 patients, and sst2 receptor expression was positive in 8 of 11. In only 1 patient were both receptors expressed. In 1 patient, GLP-1 receptor imaging was the only method that successfully localized the primary tumor in the pancreas. In 3 patients with sst2-expressing tumors, DOTATATE radiotherapy was effectively applied. Conclusion: As opposed to benign insulinomas, malignant insulinomas often lack GLP-1 receptors. Conversely, malignant insulinomas often express sst2, which can be targeted therapeutically.

Original languageEnglish
Pages (from-to)1073-1078
Number of pages6
JournalJournal of Nuclear Medicine
Volume52
Issue number7
DOIs
StatePublished - 1 Jul 2011
Externally publishedYes

Keywords

  • Glucagon-like peptide-1 receptor targeting
  • Insulinoma
  • Peptide receptor radionuclide therapy
  • Somatostatin receptor subtype 2 targeting

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