PRRT (peptide receptor radionuclide therapy)
A radioactive drug for neuroendocrine tumours: a small peptide that homes to the somatostatin receptor on the tumour cells carries lutetium-177, which irradiates them from within. Given four times, two months apart.
Neuroendocrine tumours overexpress somatostatin receptor 2, imaged with gallium-68 or copper-64 DOTATATE PET and treated first with cold somatostatin analogues (octreotide, lanreotide) for symptom and growth control. 177Lu-DOTATATE (NETTER-1, approved 2018) improved progression-free survival dramatically in midgut NETs and NETTER-2 (2024) moved it to first line in high-grade tumours; 177Lu-edotreotide (COMPETE) followed. Alpha-emitting versions (212Pb-DOTAMTATE, 225Ac-DOTATATE) are in phase 3 for PRRT-refractory disease. Toxicities are marrow suppression, kidney dose and a small risk of MDS. Together with radioiodine and PSMA therapy it defines the theranostic model.
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