{"entity":{"id":"lu177-radioligand-therapy","kind":"technology","name":"Lutetium-177 radioligand therapy","aka":["177Lu","Lu-177","Lutetium-177"],"tldr":"Cancer-seeking molecules carrying the radioactive metal lutetium-177, which delivers short-range radiation to tumours it binds; approved for neuroendocrine tumours and prostate cancer.","summary":"Lutetium-177 emits beta particles with a range of a few millimetres and gamma rays that allow imaging, making it the workhorse isotope of radioligand therapy. Lutathera (Lu-177 dotatate, approved 2018) targets somatostatin receptors on neuroendocrine tumours, and Pluvicto (Lu-177 PSMA-617, approved 2022) targets PSMA on prostate cancer; both improved outcomes in randomised trials. Supply of no-carrier-added lutetium, dosimetry and combinations with earlier lines of therapy are the current frontiers.","status":"approved","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Lutetium-177","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Lutetium-177"}],"tags":[],"related":["lu-177"],"indications":["prostate","neuroendocrine"],"sections":[],"technologies":["radioligand-therapy","therapy-isotope-supply-chain"],"targets":["psma","sstr2"],"drugs":["pluvicto","lutathera"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["nct06184035","nct05547061"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":["radioligand-therapy","therapy-isotope-supply-chain"],"notes":[],"principle":"A peptide or small molecule with high affinity for a tumour receptor is chelated to Lu-177 and infused; bound molecules irradiate the cell and its neighbours over the isotope's 6.6-day half-life.","strengths":["Randomised survival benefit in two diseases","Companion PET imaging selects patients","Tolerable toxicity profile"],"limitations":["Isotope supply and logistics","Marrow and kidney dose limits","Resistance and heterogeneous uptake"],"since":2018},"route":"/technologies/lu177-radioligand-therapy/","neighbours":{"isotope":[{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"}],"indication":[{"id":"neuroendocrine","kind":"indication","name":"Neuroendocrine tumours","route":"/indications/neuroendocrine/"},{"id":"prostate","kind":"indication","name":"Prostate cancer","route":"/indications/prostate/"}],"technology":[{"id":"radioligand-dosimetry","kind":"technology","name":"Radioligand dosimetry","route":"/technologies/radioligand-dosimetry/"},{"id":"radioligand-therapy","kind":"technology","name":"Radioligand therapy (beta emitters)","route":"/technologies/radioligand-therapy/"},{"id":"spect-dosimetry-workflow","kind":"technology","name":"SPECT dosimetry workflow for radionuclide therapy","route":"/technologies/spect-dosimetry-workflow/"},{"id":"therapy-isotope-supply-chain","kind":"technology","name":"Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)","route":"/technologies/therapy-isotope-supply-chain/"}],"target":[{"id":"psma","kind":"target","name":"PSMA","route":"/targets/psma/"},{"id":"sstr2","kind":"target","name":"Somatostatin receptor 2","route":"/targets/sstr2/"}],"drug":[{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","route":"/drugs/lutathera/"},{"id":"pluvicto","kind":"drug","name":"Lutetium-177 vipivotide tetraxetan","route":"/drugs/pluvicto/"}],"trial":[{"id":"nct06184035","kind":"trial","name":"A Dose Escalation and Expansion Study of [177Lu]Lu-SN201 in Participants With Advanced Cancer","route":"/trials/nct06184035/"},{"id":"nct05547061","kind":"trial","name":"A Phase 1/2 Clinical Trial to Evaluate the Safety, Tolerability, Dosimetry, and Anti-tumor Activity of Ga-68-NGUL / Lu-177-DGUL in Patients With Metastatic Castration-resistant Prostate Cancer (mCRPC) Refractory to Standard Therapy","route":"/trials/nct05547061/"}],"institution":[{"id":"curanosticum","kind":"institution","name":"Curanosticum Wiesbaden-Frankfurt","route":"/institutions/curanosticum/"}],"person":[{"id":"michael-lassmann","kind":"person","name":"Michael Lassmann","route":"/people/michael-lassmann/"},{"id":"richard-baum","kind":"person","name":"Richard P. Baum","route":"/people/richard-baum/"},{"id":"wolfgang-fendler","kind":"person","name":"Wolfgang P. Fendler","route":"/people/wolfgang-fendler/"}],"bottleneck":[{"id":"b-rlt-trial-capacity","kind":"bottleneck","name":"Clinical trial capacity for radioligand therapy","route":"/bottlenecks/b-rlt-trial-capacity/"},{"id":"b-enriched-target-material","kind":"bottleneck","name":"Enriched target material for therapeutic isotopes","route":"/bottlenecks/b-enriched-target-material/"},{"id":"b-hot-lab-capacity","kind":"bottleneck","name":"Hot lab and shielded treatment room capacity","route":"/bottlenecks/b-hot-lab-capacity/"},{"id":"b-radioactive-waste-regulation","kind":"bottleneck","name":"Radioactive waste handling and disposal regulation","route":"/bottlenecks/b-radioactive-waste-regulation/"}],"section":[{"id":"f-radioligand-therapy","kind":"section","name":"Radioligand therapy","route":"/fronts/f-radioligand-therapy/"}],"idea":[{"id":"idea-tb161-instead-of-lu177","kind":"idea","name":"Terbium-161 instead of lutetium-177 in the same ligands","route":"/ideas/idea-tb161-instead-of-lu177/"}],"paper":[{"id":"paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022","kind":"paper","name":"EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands","route":"/key-papers/paper-eanm-lu177-dosimetry-recommendations-ejnmmi-2022/"},{"id":"paper-hofman-lupsma-lancet-oncol-2018","kind":"paper","name":"LuPSMA trial: single-arm phase 2 study of 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer","route":"/key-papers/paper-hofman-lupsma-lancet-oncol-2018/"},{"id":"paper-therap-lancet-2021","kind":"paper","name":"TheraP: [177Lu]Lu-PSMA-617 versus cabazitaxel in metastatic castration-resistant prostate cancer","route":"/key-papers/paper-therap-lancet-2021/"}],"roadmap":[{"id":"psma-theranostics-roadmap","kind":"roadmap","name":"PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha","route":"/roadmaps/psma-theranostics-roadmap/"}],"term":[{"id":"activity-prescription","kind":"term","name":"Activity prescription: fixed versus dosimetry-guided dosing","route":"/terms/activity-prescription/"},{"id":"becquerel-curie","kind":"term","name":"Becquerel and curie (units of radioactivity)","route":"/terms/becquerel-curie/"},{"id":"mird-formalism","kind":"term","name":"MIRD formalism","route":"/terms/mird-formalism/"},{"id":"radiolysis","kind":"term","name":"Radiolysis (self-radiolysis of radiopharmaceuticals)","route":"/terms/radiolysis/"}]}}