{"entity":{"id":"prrt","kind":"technology","name":"Peptide receptor radionuclide therapy (PRRT)","aka":[],"tldr":"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.","status":"approved","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Peptide_receptor_radionuclide_therapy","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Peptide_receptor_radionuclide_therapy"}],"tags":[],"related":["lu-177","ac-225","pb-212"],"indications":["neuroendocrine"],"sections":[],"technologies":["radioligand-therapy","targeted-alpha-therapy","sstr-pet"],"targets":["sstr2"],"drugs":["lutathera","itm-11","alphamedix","ryz101"],"companies":["novartis","itm","orano-med","radiomedix","rayzebio"],"institutions":[],"pathways":[],"terms":[],"trials":["netter-1"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":["radioligand-therapy","sstr-pet"],"notes":[],"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.","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"],"since":2018},"route":"/technologies/prrt/","neighbours":{"isotope":[{"id":"ac-225","kind":"isotope","name":"Actinium-225","route":"/isotopes/ac-225/"},{"id":"pb-212","kind":"isotope","name":"Lead-212","route":"/isotopes/pb-212/"},{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"},{"id":"sc-47","kind":"isotope","name":"Scandium-47","route":"/isotopes/sc-47/"},{"id":"tb-161","kind":"isotope","name":"Terbium-161","route":"/isotopes/tb-161/"}],"indication":[{"id":"grade-3-net","kind":"indication","name":"Grade 3 well-differentiated neuroendocrine tumour","route":"/indications/grade-3-net/"},{"id":"hereditary-ppgl","kind":"indication","name":"Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127)","route":"/indications/hereditary-ppgl/"},{"id":"lung-net","kind":"indication","name":"Lung neuroendocrine tumours (typical and atypical carcinoid)","route":"/indications/lung-net/"},{"id":"meningioma","kind":"indication","name":"Meningioma","route":"/indications/meningioma/"},{"id":"metastatic-ppgl","kind":"indication","name":"Metastatic pheochromocytoma and paraganglioma","route":"/indications/metastatic-ppgl/"},{"id":"multiple-endocrine-neoplasia","kind":"indication","name":"Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)","route":"/indications/multiple-endocrine-neoplasia/"},{"id":"neuroendocrine","kind":"indication","name":"Neuroendocrine tumours","route":"/indications/neuroendocrine/"},{"id":"pancreatic-net","kind":"indication","name":"Pancreatic neuroendocrine tumours","route":"/indications/pancreatic-net/"},{"id":"pheochromocytoma-paraganglioma","kind":"indication","name":"Pheochromocytoma and paraganglioma (PPGL)","route":"/indications/pheochromocytoma-paraganglioma/"},{"id":"small-intestinal-net","kind":"indication","name":"Small intestinal neuroendocrine tumours","route":"/indications/small-intestinal-net/"}],"technology":[{"id":"dota-chelation","kind":"technology","name":"DOTA chelation","route":"/technologies/dota-chelation/"},{"id":"radioligand-therapy","kind":"technology","name":"Radioligand therapy (beta emitters)","route":"/technologies/radioligand-therapy/"},{"id":"sstr-pet","kind":"technology","name":"Somatostatin receptor PET (68Ga/64Cu-DOTATATE)","route":"/technologies/sstr-pet/"},{"id":"spect-dosimetry-workflow","kind":"technology","name":"SPECT dosimetry workflow for radionuclide therapy","route":"/technologies/spect-dosimetry-workflow/"},{"id":"targeted-alpha-therapy","kind":"technology","name":"Targeted alpha therapy","route":"/technologies/targeted-alpha-therapy/"}],"target":[{"id":"sstr2","kind":"target","name":"Somatostatin receptor 2","route":"/targets/sstr2/"}],"drug":[{"id":"itm-11","kind":"drug","name":"177Lu-edotreotide","route":"/drugs/itm-11/"},{"id":"alphamedix","kind":"drug","name":"212Pb-DOTAMTATE","route":"/drugs/alphamedix/"},{"id":"ryz101","kind":"drug","name":"Actinium-225 DOTATATE","route":"/drugs/ryz101/"},{"id":"ga68-dotatate","kind":"drug","name":"Gallium-68 DOTATATE (and Cu-64 DOTATATE)","route":"/drugs/ga68-dotatate/"},{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","route":"/drugs/lutathera/"},{"id":"lu-177-dotatate-generic","kind":"drug","name":"Lutetium-177 dotatate (radioligand equivalent)","route":"/drugs/lu-177-dotatate-generic/"}],"company":[{"id":"itm","kind":"company","name":"ITM Isotope Technologies Munich","route":"/companies/itm/"},{"id":"molecular-targeting-technologies","kind":"company","name":"Molecular Targeting Technologies","route":"/companies/molecular-targeting-technologies/"},{"id":"novartis","kind":"company","name":"Novartis","route":"/companies/novartis/"},{"id":"orano-med","kind":"company","name":"Orano Med","route":"/companies/orano-med/"},{"id":"radiomedix","kind":"company","name":"RadioMedix","route":"/companies/radiomedix/"},{"id":"rayzebio","kind":"company","name":"RayzeBio (BMS)","route":"/companies/rayzebio/"}],"trial":[{"id":"alphamedix-02","kind":"trial","name":"ALPHAMEDIX-02","route":"/trials/alphamedix-02/"},{"id":"compete","kind":"trial","name":"COMPETE","route":"/trials/compete/"},{"id":"netter-1","kind":"trial","name":"NETTER-1","route":"/trials/netter-1/"}],"term":[{"id":"activity-prescription","kind":"term","name":"Activity prescription: fixed versus dosimetry-guided dosing","route":"/terms/activity-prescription/"},{"id":"fixed-versus-personalised-dosing","kind":"term","name":"Fixed versus personalised (dosimetry-guided) dosing","route":"/terms/fixed-versus-personalised-dosing/"},{"id":"krenning-score","kind":"term","name":"Krenning score","route":"/terms/krenning-score/"},{"id":"myelosuppression-after-rlt","kind":"term","name":"Myelosuppression after radioligand therapy","route":"/terms/myelosuppression-after-rlt/"},{"id":"prrt-term","kind":"term","name":"PRRT (peptide receptor radionuclide therapy)","route":"/terms/prrt-term/"},{"id":"radioiodine-term","kind":"term","name":"Radioiodine therapy (I-131)","route":"/terms/radioiodine-term/"},{"id":"renal-protection-amino-acids","kind":"term","name":"Renal protection with amino acid co-infusion","route":"/terms/renal-protection-amino-acids/"}],"pairing":[{"id":"ga68-dotatate-then-lutathera","kind":"pairing","name":"68Ga-DOTATATE PET before Lutathera (177Lu-DOTATATE)","route":"/pairings/ga68-dotatate-then-lutathera/"},{"id":"prrt-plus-captem","kind":"pairing","name":"PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)","route":"/pairings/prrt-plus-captem/"},{"id":"sstr-pet-to-prrt","kind":"pairing","name":"SSTR PET → PRRT","route":"/pairings/sstr-pet-to-prrt/"}],"idea":[{"id":"idea-net-dosimetry-prrt","kind":"idea","name":"Dosimetry-personalised PRRT instead of four fixed cycles","route":"/ideas/idea-net-dosimetry-prrt/"},{"id":"idea-net-antagonist-ligands","kind":"idea","name":"SSTR antagonist radioligands to increase tumour dose","route":"/ideas/idea-net-antagonist-ligands/"},{"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/"}],"bottleneck":[{"id":"b-authorized-user-shortage","kind":"bottleneck","name":"Authorized user shortage for radionuclide therapy","route":"/bottlenecks/b-authorized-user-shortage/"},{"id":"b-dosimetry-standardisation","kind":"bottleneck","name":"Dosimetry standardisation for radioligand therapy","route":"/bottlenecks/b-dosimetry-standardisation/"},{"id":"b-dose-optimisation","kind":"bottleneck","name":"Wrong doses","route":"/bottlenecks/b-dose-optimisation/"}],"section":[{"id":"f-radioligand-therapy","kind":"section","name":"Radioligand therapy","route":"/fronts/f-radioligand-therapy/"}],"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-strosberg-netter1-qol-jco-2018","kind":"paper","name":"Health-related quality of life in the NETTER-1 trial of 177Lu-Dotatate","route":"/key-papers/paper-strosberg-netter1-qol-jco-2018/"},{"id":"paper-baum-prrt-1048-patients-oncotarget-2018","kind":"paper","name":"Results and adverse events of personalised peptide receptor radionuclide therapy in 1048 patients with neuroendocrine neoplasms","route":"/key-papers/paper-baum-prrt-1048-patients-oncotarget-2018/"}],"person":[{"id":"erik-mittra","kind":"person","name":"Erik S. Mittra","route":"/people/erik-mittra/"},{"id":"lisa-bodei","kind":"person","name":"Lisa Bodei","route":"/people/lisa-bodei/"},{"id":"michael-lassmann","kind":"person","name":"Michael Lassmann","route":"/people/michael-lassmann/"}],"roadmap":[{"id":"alpha-therapy-roadmap","kind":"roadmap","name":"Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline","route":"/roadmaps/alpha-therapy-roadmap/"},{"id":"dosimetry-roadmap","kind":"roadmap","name":"Dosimetry roadmap: MIRD schema → fixed dosing → personalised, image-based dose","route":"/roadmaps/dosimetry-roadmap/"},{"id":"sstr-theranostics-roadmap","kind":"roadmap","name":"SSTR theranostics roadmap: octreotide scintigraphy → 68Ga-DOTATATE → 177Lu-DOTATATE → alpha","route":"/roadmaps/sstr-theranostics-roadmap/"}]}}