# Beta PRRT → alpha PRRT

Source: https://onco.cc/pairings/prrt-then-alpha-net/  
OnCo record `prrt-then-alpha-net` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

When lutetium radioligand therapy stops working, alpha-emitting versions can still control the disease.

## Summary

This sequence moves from beta-emitting lutetium-177 dotatate to an alpha-emitting radioligand, 212Pb-DOTAMTATE, when beta PRRT stops controlling a neuroendocrine tumour. Alpha particles deliver oxygen-independent clustered DNA damage that beta-resistant clones cannot repair, so the same somatostatin receptor target can be attacked again with a more destructive payload. The phase 2 ALPHAMEDIX-02 trial included a PRRT-exposed cohort in which disease control was maintained in most patients, and ACTION-1 is the randomised phase 3 test of 225Ac-DOTATATE after 177Lu. The pairing belongs to the wider topic of alpha versus beta emitters and targeted alpha therapy.

## Fields

- Kind: Pairing
- Last checked: 2026-09-07
- Pairs: Lutetium-177 dotatate + 212Pb-DOTAMTATE
- Type: sequence
- Rationale: Alpha particles deliver oxygen-independent clustered DNA damage that beta-resistant clones cannot repair.
- Evidence: Phase 2 (AlphaMedix); phase 3 pending (ACTION-1).

## Sources

- ClinicalTrials.gov NCT05153772: ALPHAMEDIX-02: https://clinicaltrials.gov/study/NCT05153772
- ClinicalTrials.gov NCT05477576: ACTION-1: https://clinicaltrials.gov/study/NCT05477576

## Connected records

- cancers: [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/)
- technologies: [Targeted alpha therapy](https://onco.cc/technologies/targeted-alpha-therapy/)
- terms: [Alpha vs beta emitters](https://onco.cc/terms/alpha-vs-beta/)
- trials: [ACTION-1](https://onco.cc/trials/action-1/), [ALPHAMEDIX-02](https://onco.cc/trials/alphamedix-02/)
- drugs: [212Pb-DOTAMTATE](https://onco.cc/drugs/alphamedix/), [Lutetium-177 dotatate](https://onco.cc/drugs/lutathera/)

---
JSON: https://onco.cc/api/v1/entities/prrt-then-alpha-net.json