Peptide receptor radionuclide therapy (PRRT)
A radioactive version of the hormone mimic used for the scan; it homes to neuroendocrine tumour cells and irradiates them from inside.
Overview
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.
How it works
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.
- Systemic, receptor-targeted
- Response and quality-of-life benefit
- Imaging selects and monitors
- Myelosuppression, rare MDS/AML (~2-3%)
- Renal dose
- Not curative; retreatment data limited
Dependencies
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A second lutetium radioligand for neuroendocrine tumours that beat the standard pill everolimus in a head-to-head trial and is awaiting an FDA decision.
An alpha-particle version of neuroendocrine radioligand therapy that produced responses in over half of patients who had never had PRRT, with FDA Breakthrough designation.
The PET scan for neuroendocrine tumours that finds far more disease than older scans and confirms eligibility for lutetium radioligand therapy (the theranostic pair).
A second, cheaper version of an already-approved radioactive drug for neuroendocrine tumours has been approved, using the same active radioactive ingredient as the original but made by a different company.
This document standardises how hospitals measure the actual radiation dose reaching a patient's kidneys and tumours during lutetium-177 treatment, laying the groundwork for shifting from a one-dose-fits-all schedule to treatment doses tailored to each patient's biology.
People treated with the radioactive drug lutetium-177 dotatate kept feeling well for much longer - years rather than months, in several measures - than people on the standard high-dose hormone injection, on top of the tumour-control benefit already shown.
In the largest reported group of neuroendocrine tumour patients treated with individually dosed radioactive peptide therapy, most people lived several years after treatment, and serious long-term harms such as blood cancers were uncommon but real, occurring in about 1 in 50 patients.
Latest papers
topQuery for this technology: (TITLE:"Peptide receptor radionuclide therapy" OR ABSTRACT:"Peptide receptor radionuclide therapy" OR TITLE:"PRRT" OR ABSTRACT:"PRRT") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Peptide receptor radionuclide therapy (PRRT), not a curated reading list.
Similar pages
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Shares Michael Lassmann, Terbium-161 instead of lutetium-177 in the same ligands, Activity prescription: fixed versus dosimetry-guided dosing, EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands.
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- PersonJonathan R. Strosberg
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