# Peptide receptor radionuclide therapy (PRRT)

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

## TL;DR

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.

## Fields

- Kind: Technology
- Status: approved
- Last checked: 2026-09-07
- 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.
- Since: 2018
- 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

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Peptide_receptor_radionuclide_therapy
- Wikipedia: https://en.wikipedia.org/wiki/Peptide_receptor_radionuclide_therapy

## Connected records

- cancers: [Esthesioneuroblastoma (olfactory neuroblastoma)](https://onco.cc/cancers/esthesioneuroblastoma/), [Glucagonoma](https://onco.cc/cancers/glucagonoma/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/), [Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127)](https://onco.cc/cancers/hereditary-ppgl/), [Lung neuroendocrine tumours (typical and atypical carcinoid)](https://onco.cc/cancers/lung-net/), [Meningioma](https://onco.cc/cancers/meningioma/), [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)](https://onco.cc/cancers/multiple-endocrine-neoplasia/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/), [Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma](https://onco.cc/cancers/pituitary-tumours/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/), [Somatostatinoma](https://onco.cc/cancers/somatostatinoma/), [VIPoma](https://onco.cc/cancers/vipoma/)
- fronts: [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/)
- technologies: [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/), [Somatostatin receptor PET (68Ga/64Cu-DOTATATE)](https://onco.cc/technologies/sstr-pet/), [Targeted alpha therapy](https://onco.cc/technologies/targeted-alpha-therapy/)
- targets: [Somatostatin receptor 2](https://onco.cc/targets/sstr2/)
- drugs: [177Lu-edotreotide](https://onco.cc/drugs/itm-11/), [212Pb-DOTAMTATE](https://onco.cc/drugs/alphamedix/), [Actinium-225 DOTATATE](https://onco.cc/drugs/ryz101/), [Gallium-68 DOTATATE (and Cu-64 DOTATATE)](https://onco.cc/drugs/ga68-dotatate/), [Lutetium-177 dotatate](https://onco.cc/drugs/lutathera/)
- companies: [ITM Isotope Technologies Munich](https://onco.cc/companies/itm/), [Novartis](https://onco.cc/companies/novartis/), [Orano Med](https://onco.cc/companies/orano-med/), [RadioMedix](https://onco.cc/companies/radiomedix/), [RayzeBio (BMS)](https://onco.cc/companies/rayzebio/)
- trials: [ALPHAMEDIX-02](https://onco.cc/trials/alphamedix-02/), [COMPETE](https://onco.cc/trials/compete/), [Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE](https://onco.cc/trials/nct04919226/), [NETTER-1](https://onco.cc/trials/netter-1/)
- pairings: [SSTR PET → PRRT](https://onco.cc/pairings/sstr-pet-to-prrt/)
- ideas: [Dosimetry-personalised PRRT instead of four fixed cycles](https://onco.cc/ideas/idea-net-dosimetry-prrt/), [SSTR antagonist radioligands to increase tumour dose](https://onco.cc/ideas/idea-net-antagonist-ligands/)
- bottlenecks: [Wrong doses](https://onco.cc/bottlenecks/b-dose-optimisation/)
- terms: [PRRT (peptide receptor radionuclide therapy)](https://onco.cc/terms/prrt-term/), [Radioiodine therapy (I-131)](https://onco.cc/terms/radioiodine-term/)

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