# Peptide receptor radionuclide therapy (PRRT)

Source: https://nuclide.cc/technologies/prrt/  
Nuclide record `prrt` (Technology). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

A radioactive version of the hormone mimic used for the scan; it homes to neuroendocrine tumour cells and irradiates them from inside.

## Summary

177Lu-DOTATATE (Lutathera; NETTER-1 second line, NETTER-2 first line in grade 2-3) is the reference. 177Lu-edotreotide (ITM-11, COMPETE: PFS 23.9 vs 14.1 months vs everolimus; FDA PDUFA 28 August 2026) is the second beta-emitter. Alpha PRRT with 212Pb-DOTAMTATE (AlphaMedix, Breakthrough designation; phase 2 ORR 54% in PRRT-naive) and 225Ac-DOTATATE (RYZ101, ACTION-1 phase 3) aims at beta-refractory disease. Antagonist ligands (177Lu-satoreotide) bind more receptor sites than agonists.

## Fields

- Kind: Technology
- Status: approved
- Last checked: 2026-09-07
- Principle: An SSTR2-binding peptide is chelated to a therapeutic radionuclide and internalised by the tumour cell; beta (177Lu) or alpha (212Pb, 225Ac) emission; usually four cycles.
- Since: 2018
- Strengths: Systemic, receptor-targeted; Response and quality-of-life benefit; Imaging selects and monitors
- Limitations: Myelosuppression, rare MDS/AML (~2-3%); Renal dose; Not curative; retreatment data limited

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Peptide_receptor_radionuclide_therapy
- Wikipedia: https://en.wikipedia.org/wiki/Peptide_receptor_radionuclide_therapy

## Connected records

- isotopes: [Actinium-225](https://nuclide.cc/isotopes/ac-225/), [Lead-212](https://nuclide.cc/isotopes/pb-212/), [Lutetium-177](https://nuclide.cc/isotopes/lu-177/), [Scandium-47](https://nuclide.cc/isotopes/sc-47/), [Terbium-161](https://nuclide.cc/isotopes/tb-161/)
- indications: [Grade 3 well-differentiated neuroendocrine tumour](https://nuclide.cc/indications/grade-3-net/), [Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127)](https://nuclide.cc/indications/hereditary-ppgl/), [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://nuclide.cc/indications/lung-net/), [Meningioma](https://nuclide.cc/indications/meningioma/), [Metastatic pheochromocytoma and paraganglioma](https://nuclide.cc/indications/metastatic-ppgl/), [Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)](https://nuclide.cc/indications/multiple-endocrine-neoplasia/), [Neuroendocrine tumours](https://nuclide.cc/indications/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://nuclide.cc/indications/pancreatic-net/), [Pheochromocytoma and paraganglioma (PPGL)](https://nuclide.cc/indications/pheochromocytoma-paraganglioma/), [Small intestinal neuroendocrine tumours](https://nuclide.cc/indications/small-intestinal-net/)
- technologies: [DOTA chelation](https://nuclide.cc/technologies/dota-chelation/), [Radioligand therapy (beta emitters)](https://nuclide.cc/technologies/radioligand-therapy/), [Somatostatin receptor PET (68Ga/64Cu-DOTATATE)](https://nuclide.cc/technologies/sstr-pet/), [SPECT dosimetry workflow for radionuclide therapy](https://nuclide.cc/technologies/spect-dosimetry-workflow/), [Targeted alpha therapy](https://nuclide.cc/technologies/targeted-alpha-therapy/)
- targets: [Somatostatin receptor 2](https://nuclide.cc/targets/sstr2/)
- drugs: [177Lu-edotreotide](https://nuclide.cc/drugs/itm-11/), [212Pb-DOTAMTATE](https://nuclide.cc/drugs/alphamedix/), [Actinium-225 DOTATATE](https://nuclide.cc/drugs/ryz101/), [Gallium-68 DOTATATE (and Cu-64 DOTATATE)](https://nuclide.cc/drugs/ga68-dotatate/), [Lutetium-177 dotatate](https://nuclide.cc/drugs/lutathera/), [Lutetium-177 dotatate (radioligand equivalent)](https://nuclide.cc/drugs/lu-177-dotatate-generic/)
- companies: [ITM Isotope Technologies Munich](https://nuclide.cc/companies/itm/), [Molecular Targeting Technologies](https://nuclide.cc/companies/molecular-targeting-technologies/), [Novartis](https://nuclide.cc/companies/novartis/), [Orano Med](https://nuclide.cc/companies/orano-med/), [RadioMedix](https://nuclide.cc/companies/radiomedix/), [RayzeBio (BMS)](https://nuclide.cc/companies/rayzebio/)
- trials: [ALPHAMEDIX-02](https://nuclide.cc/trials/alphamedix-02/), [COMPETE](https://nuclide.cc/trials/compete/), [NETTER-1](https://nuclide.cc/trials/netter-1/)
- terms: [Activity prescription: fixed versus dosimetry-guided dosing](https://nuclide.cc/terms/activity-prescription/), [Fixed versus personalised (dosimetry-guided) dosing](https://nuclide.cc/terms/fixed-versus-personalised-dosing/), [Krenning score](https://nuclide.cc/terms/krenning-score/), [Myelosuppression after radioligand therapy](https://nuclide.cc/terms/myelosuppression-after-rlt/), [PRRT (peptide receptor radionuclide therapy)](https://nuclide.cc/terms/prrt-term/), [Radioiodine therapy (I-131)](https://nuclide.cc/terms/radioiodine-term/), [Renal protection with amino acid co-infusion](https://nuclide.cc/terms/renal-protection-amino-acids/)
- pairings: [68Ga-DOTATATE PET before Lutathera (177Lu-DOTATATE)](https://nuclide.cc/pairings/ga68-dotatate-then-lutathera/), [PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)](https://nuclide.cc/pairings/prrt-plus-captem/), [SSTR PET → PRRT](https://nuclide.cc/pairings/sstr-pet-to-prrt/)
- ideas: [Dosimetry-personalised PRRT instead of four fixed cycles](https://nuclide.cc/ideas/idea-net-dosimetry-prrt/), [SSTR antagonist radioligands to increase tumour dose](https://nuclide.cc/ideas/idea-net-antagonist-ligands/), [Terbium-161 instead of lutetium-177 in the same ligands](https://nuclide.cc/ideas/idea-tb161-instead-of-lu177/)
- bottlenecks: [Authorized user shortage for radionuclide therapy](https://nuclide.cc/bottlenecks/b-authorized-user-shortage/), [Dosimetry standardisation for radioligand therapy](https://nuclide.cc/bottlenecks/b-dosimetry-standardisation/), [Wrong doses](https://nuclide.cc/bottlenecks/b-dose-optimisation/)
- fronts: [Radioligand therapy](https://nuclide.cc/fronts/f-radioligand-therapy/)
- key papers: [EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands](https://nuclide.cc/key-papers/paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022/), [Health-related quality of life in the NETTER-1 trial of 177Lu-Dotatate](https://nuclide.cc/key-papers/paper-strosberg-netter1-qol-jco-2018/), [Results and adverse events of personalised peptide receptor radionuclide therapy in 1048 patients with neuroendocrine neoplasms](https://nuclide.cc/key-papers/paper-baum-prrt-1048-patients-oncotarget-2018/)
- people: [Erik S. Mittra](https://nuclide.cc/people/erik-mittra/), [Lisa Bodei](https://nuclide.cc/people/lisa-bodei/), [Michael Lassmann](https://nuclide.cc/people/michael-lassmann/)
- roadmaps: [Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline](https://nuclide.cc/roadmaps/alpha-therapy-roadmap/), [Dosimetry roadmap: MIRD schema → fixed dosing → personalised, image-based dose](https://nuclide.cc/roadmaps/dosimetry-roadmap/), [SSTR theranostics roadmap: octreotide scintigraphy → 68Ga-DOTATATE → 177Lu-DOTATATE → alpha](https://nuclide.cc/roadmaps/sstr-theranostics-roadmap/)

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JSON: https://nuclide.cc/api/v1/entities/prrt.json