A patient with both sickle cell anemia and metastatic neuroendocrine tumor safely completed four cycles of 177Lu-DOTATATE peptide receptor therapy with stable disease for 13 months and a 45% drop in tumor marker levels.
45% decline in tumor markerSerum chromogranin A levels dropped by 45% after 4 cycles of PRRT, indicating meaningful anti-tumor activity despite the patient's concurrent sickle cell anemia.
What the researchers found
The patient successfully completed 4 cycles of PRRT with 177Lu-DOTATATE despite having sickle cell anemia, a condition that could potentially complicate this type of therapy. Renal, hematologic, and liver lab values remained stable throughout treatment. Post-treatment, the disease remained stable for up to 13 months, and serum chromogranin A levels — a key tumor marker for neuroendocrine tumors — declined by 45%.
This is the first reported case demonstrating that PRRT can be safely administered to patients with sickle cell anemia, a population typically excluded from clinical trials due to concerns about hematologic complications.
Why it matters
Patients with sickle cell anemia are often excluded from treatments like PRRT due to concerns about worsening blood-related side effects. This case provides the first evidence that such patients can safely receive this peptide-based targeted radiation therapy, potentially opening up an important treatment option for an underserved patient population with neuroendocrine tumors.
How the study worked
This was a single-patient case report. A 56-year-old woman with sickle cell anemia and metastatic neuroendocrine tumor that was refractory to somatostatin analog therapy received 4 cycles of PRRT with 177Lu-DOTATATE. Researchers monitored her renal function, hematologic parameters, liver labs, disease status, and serum chromogranin levels throughout and after treatment.
What this study cannot tell us
As a single case report, the findings cannot be generalized to all patients with sickle cell anemia. There was no comparison group, and the treatment schedule was disrupted by hospitalizations, making it difficult to assess whether the delays affected efficacy. Long-term outcomes beyond 13 months were not reported.
How to read the evidence
This is a single case report, which represents the lowest level of clinical evidence. While it provides valuable first-of-its-kind safety data, it cannot establish efficacy or be generalized without larger studies.
When this study was published
Published in 2025, this is a very recent case report reflecting current PRRT practices and protocols.
The bigger picture
PRRT with 177Lu-DOTATATE (marketed as Lutathera) has become a standard treatment for somatostatin receptor-positive neuroendocrine tumors. However, clinical trials typically exclude patients with comorbidities like sickle cell anemia. This case report expands the evidence base for PRRT safety in complex patient populations and highlights the need for flexible treatment scheduling when managing patients with concurrent chronic conditions.
Questions still open
- Would PRRT outcomes differ if treatment scheduling were not disrupted by sickle cell-related hospitalizations?
- Is hematologic toxicity from PRRT different in patients with sickle cell anemia compared to the general population over longer follow-up periods?
- Could prophylactic management of sickle cell crises improve PRRT treatment adherence and outcomes?
Common questions
What is peptide receptor radionuclide therapy (PRRT)?
Why is this case report significant for patients with sickle cell anemia?
Read the original research
Feasibility and Safety of Peptide Receptor Radionuclide Therapy With 177 Lu-DOTATATE for Neuroendocrine Tumor in a Patient With Sickle Cell Anemia.
Clinical nuclear medicine, 50(11), e661-e664
Citation
Lawal, Ismaheel O; Gbolahan, Olumide B; Marcus, Charles; Jones, Aaron T; Shaib, Walid L; Muzahir, Saima. (2025). Feasibility and Safety of Peptide Receptor Radionuclide Therapy With 177 Lu-DOTATATE for Neuroendocrine Tumor in a Patient With Sickle Cell Anemia.. Clinical nuclear medicine, 50(11), e661-e664. https://doi.org/10.1097/RLU.0000000000005790