# Radioligand therapy (beta emitters)

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

## TL;DR

A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.

## Summary

177Lu-DOTATATE (Lutathera, 2018) in neuroendocrine tumours and 177Lu-PSMA-617 (Pluvicto, 2022; pre-chemotherapy label 2025; 2026 label expansion) in prostate cancer are the approved beta-emitter therapies. Pipeline: 177Lu-FAP, 177Lu-PSMA-I&T, 177Lu-NeoB (GRPR), 177Lu-labelled antibodies. Dosimetry-guided personalised dosing is emerging.

## Fields

- Kind: Technology
- Status: approved
- Last checked: 2026-09-04
- Principle: 177Lu emits beta particles with ~2 mm range and gamma photons for SPECT imaging; the ligand determines biodistribution.
- Since: 2018
- Strengths: Systemic, whole-body targeting of microscopic disease; Crossfire kills antigen-negative neighbours; Imaging companion selects patients
- Limitations: Marrow and kidney dose; Isotope logistics (6.7-day half-life); Not curative alone

## Sources

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

## Connected records

- cancers: [Esthesioneuroblastoma (olfactory neuroblastoma)](https://onco.cc/cancers/esthesioneuroblastoma/), [Grade 3 well-differentiated neuroendocrine tumour](https://onco.cc/cancers/grade-3-net/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/), [Hereditary pheochromocytoma and paraganglioma (SDHx, VHL, RET, NF1, MAX and TMEM127)](https://onco.cc/cancers/hereditary-ppgl/), [Metastatic pheochromocytoma and paraganglioma](https://onco.cc/cancers/metastatic-ppgl/), [Neuroblastoma (paediatric)](https://onco.cc/cancers/neuroblastoma/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Osteosarcoma](https://onco.cc/cancers/osteosarcoma/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Pheochromocytoma and paraganglioma (PPGL)](https://onco.cc/cancers/pheochromocytoma-paraganglioma/), [Prostate cancer](https://onco.cc/cancers/prostate/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/), [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- fronts: [Radiation Therapy](https://onco.cc/fronts/radiation/), [Radiopharmaceuticals & Theranostics](https://onco.cc/fronts/radiopharma/)
- technologies: [Alpha-emitter nanogenerators and daughter trapping](https://onco.cc/technologies/alpha-nanogenerators/), [Astatine-211 alpha therapy](https://onco.cc/technologies/astatine-211-alpha-therapy/), [Auger-electron therapy](https://onco.cc/technologies/auger-electron-therapy/), [De novo designed protein binders](https://onco.cc/technologies/de-novo-protein-design/), [Gamma probes, handheld gamma cameras and dose calibrators](https://onco.cc/technologies/gamma-probes-dose-calibrators/), [Lutetium-177 radioligand therapy](https://onco.cc/technologies/lu177-radioligand-therapy/), [Medical cyclotrons, hot cells, and synthesis modules](https://onco.cc/technologies/medical-cyclotrons-synthesis-modules/), [MIBG imaging and 131I-MIBG therapy](https://onco.cc/technologies/mibg-theranostics/), [Nuclear medicine and total-body PET hardware](https://onco.cc/technologies/nuclear-medicine-hardware/), [Peptide receptor radionuclide therapy (PRRT)](https://onco.cc/technologies/prrt/), [PET/CT](https://onco.cc/technologies/pet-ct/), [PSMA PET](https://onco.cc/technologies/psma-pet/), [Radioembolisation (TARE / SIRT, yttrium-90)](https://onco.cc/technologies/radioembolisation-tare/), [Radioiodine therapy and whole-body iodine scanning](https://onco.cc/technologies/radioiodine-therapy/), [Radioligand dosimetry](https://onco.cc/technologies/radioligand-dosimetry/), [Radioligand plus DNA-repair inhibitor combinations](https://onco.cc/technologies/radionuclide-parp-combination/), [Radiopharmaceutical GMP and releasing a drug that decays](https://onco.cc/technologies/radiopharmaceutical-gmp-release/), [Radiopharmacy and cyclotron networks](https://onco.cc/technologies/radiopharmacy-network/), [Research reactors for medical isotopes (Mo-99, Lu-177, I-131)](https://onco.cc/technologies/research-reactor-isotope-production/), [SPECT & bone scan](https://onco.cc/technologies/spect/), [SPECT/CT](https://onco.cc/technologies/spect-ct/), [Targeted alpha therapy](https://onco.cc/technologies/targeted-alpha-therapy/), [Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225)](https://onco.cc/technologies/therapy-isotope-supply-chain/)
- targets: [CXCR4](https://onco.cc/targets/cxcr4/), [FAP](https://onco.cc/targets/fap/), [GRPR (gastrin-releasing peptide receptor)](https://onco.cc/targets/grpr/), [PSMA](https://onco.cc/targets/psma/), [Somatostatin receptor 2](https://onco.cc/targets/sstr2/)
- drugs: [131I-MIBG (iobenguane I-131) therapy](https://onco.cc/drugs/i131-mibg/), [177Lu-edotreotide](https://onco.cc/drugs/itm-11/), [177Lu-PSMA-I&T](https://onco.cc/drugs/lu177-psma-it/), [FAP-2286 (177Lu / 68Ga)](https://onco.cc/drugs/fap-2286/), [Gallium-68 DOTATATE (and Cu-64 DOTATATE)](https://onco.cc/drugs/ga68-dotatate/), [Iomab-B](https://onco.cc/drugs/iomab-b/), [Locametz (kit for Ga-68 gozetotide)](https://onco.cc/drugs/locametz/), [Lutetium-177 dotatate](https://onco.cc/drugs/lutathera/), [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [Radioactive iodine (I-131)](https://onco.cc/drugs/radioactive-iodine/), [Samarium-153 lexidronam](https://onco.cc/drugs/samarium-153-lexidronam/)
- companies: [Abdera Therapeutics](https://onco.cc/companies/abdera-therapeutics/), [Advanced Accelerator Applications (Novartis)](https://onco.cc/companies/advanced-accelerator-applications/), [Alpha-9 Oncology](https://onco.cc/companies/alpha-9-oncology/), [ANZUP Cancer Trials Group](https://onco.cc/companies/anzup/), [Ariceum Therapeutics](https://onco.cc/companies/ariceum-therapeutics/), [ARTBIO](https://onco.cc/companies/artbio/), [Atomic Alchemy](https://onco.cc/companies/atomic-alchemy/), [Clarity Pharmaceuticals](https://onco.cc/companies/clarity-pharmaceuticals/), [Evergreen Theragnostics](https://onco.cc/companies/evergreen-theragnostics/), [Mariana Oncology](https://onco.cc/companies/mariana-oncology/), [MIM Software (GE HealthCare)](https://onco.cc/companies/mim-software/), [Monopar Therapeutics](https://onco.cc/companies/monopar/), [Nucleus RadioPharma](https://onco.cc/companies/nucleus-radiopharma/), [POINT Biopharma](https://onco.cc/companies/point-biopharma/), [Precirix](https://onco.cc/companies/precirix/), [Radionetics Oncology](https://onco.cc/companies/radionetics-oncology/), [Ratio Therapeutics](https://onco.cc/companies/ratio-therapeutics/), [Relit Biosciences](https://onco.cc/companies/relit-biosciences/)
- journals: [Cancer biotherapy & radiopharmaceuticals](https://onco.cc/journals/cancer-biotherapy-and-radiopharmaceuticals/), [Journal of Nuclear Medicine](https://onco.cc/journals/journal-of-nuclear-medicine/)
- trials: [A Study of 177Lu-FAP-2286 in Advanced Solid Tumors](https://onco.cc/trials/nct04939610/), [An Open-label Study Comparing Lutetium (177Lu) Vipivotide Tetraxetan Versus Observation in PSMA Positive OMPC.](https://onco.cc/trials/nct05939414/), [Anti-tumour Activity of (177Lu) rhPSMA-10.1 Injection](https://onco.cc/trials/nct05413850/), [ECLIPSE](https://onco.cc/trials/eclipse-psma/), [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/), [PSMAddition](https://onco.cc/trials/psmaddition/), [PSMAfore](https://onco.cc/trials/psmafore/), [SPLASH](https://onco.cc/trials/splash/), [Study of Iomab-B vs. Conventional Care in Older Subjects With Active, Relapsed or Refractory Acute Myeloid Leukemia](https://onco.cc/trials/nct02665065/), [Study of Lutetium (177Lu) Vipivotide Tetraxetan in mCRPC Participants With Moderately and Severely Impaired and With Normal Renal Function](https://onco.cc/trials/nct06004661/), [Study to Evaluate Safety and Dosimetry of Lutathera in Adolescent Patients With GEP-NETs and PPGLs](https://onco.cc/trials/nct04711135/), [Study to Evaluate the Diagnostic Performance of GEH300079 (68Ga) Injection PET/CT for Detection of PC in Patients With Colorectal, Gastric, Ovarian, o](https://onco.cc/trials/nct07219238/), [Study to Evaluate the Efficacy and Safety of Lutathera in Patients With Grade 2 and Grade 3 Advanced GEP-NET](https://onco.cc/trials/nct03972488/), [TheraP (ANZUP 1603)](https://onco.cc/trials/therap/), [VISION](https://onco.cc/trials/vision/)
- ideas: [A coordinated reserve and shared schedule for the world's medical isotope reactors](https://onco.cc/ideas/idea-reg-medical-isotope-reactor-reserve/), [A global medical isotope supply observatory with forecasts and shortage alerts](https://onco.cc/ideas/idea-reg-isotope-supply-observatory/), [A university cyclotron network with shared regulatory files for new tracers](https://onco.cc/ideas/idea-fund-academic-radiopharma-pipeline/), [Alpha-emitting PSMA therapy at first metastatic diagnosis](https://onco.cc/ideas/idea-alpha-first-mhspc/), [Build Western ytterbium-176 enrichment so lutetium-177 has more than one supplier](https://onco.cc/ideas/idea-reg-yb176-enrichment-capacity/), [CAIX theranostics: 89Zr-girentuximab PET and 177Lu/225Ac-girentuximab therapy](https://onco.cc/ideas/idea-caix-theranostics/), [FAP theranostics as a pan-cancer stromal strategy](https://onco.cc/ideas/idea-fap-theranostics-pancancer/), [Mutual recognition of GMP inspections for cell, gene and radiopharmaceutical plants](https://onco.cc/ideas/idea-reg-mutual-recognition-inspections-atmp/), [Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer](https://onco.cc/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/), [Recover legacy radium-226 sources worldwide as the feedstock for actinium-225](https://onco.cc/ideas/idea-reg-legacy-radium-recovery-ac225/), [Regional radiopharmacy hubs and harmonised transport rules for short-lived isotopes](https://onco.cc/ideas/idea-reg-regional-radiopharmacy-hubs/), [Regional translational institutes with academic GMP suites and IND teams](https://onco.cc/ideas/idea-fund-translational-institutes-gmp/), [Total-body PET for personalised radioligand dosing](https://onco.cc/ideas/idea-total-body-pet-dosimetry/), [Tumour-on-a-chip with blood flow to test whether big drugs actually get in](https://onco.cc/ideas/idea-bio1-tumour-on-chip-penetration/), [Which patients' blood clones will become leukaemia after treatment?](https://onco.cc/ideas/idea-chip-risk-modifiers/)
- key papers: [[ 177 Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial](https://onco.cc/key-papers/paper-therap-lancet-2021/), [NETTER-2: lutetium-177 dotatate as first treatment for higher-grade gastroenteropancreatic neuroendocrine tumours](https://onco.cc/key-papers/paper-netter-2-lancet-2024/), [Prostate-specific membrane antigen expression in normal and malignant human tissues](https://onco.cc/key-papers/paper-silver-psma-expression-normal-malignant-tissues-ccr-1997/), [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://onco.cc/key-papers/paper-vision-nejm-2021/)
- institutions: [All India Institute of Medical Sciences, New Delhi](https://onco.cc/institutions/aiims-delhi/), [Centre Jean Perrin](https://onco.cc/institutions/centre-jean-perrin/), [Chris O'Brien Lifehouse](https://onco.cc/institutions/chris-obrien-lifehouse/), [Chulabhorn Hospital / Chulabhorn Royal Academy](https://onco.cc/institutions/chulabhorn-hospital/), [Cleveland Clinic Abu Dhabi](https://onco.cc/institutions/cleveland-clinic-abu-dhabi/), [Comprehensive Cancer Center Mainfranken, University Hospital Würzburg](https://onco.cc/institutions/ccc-wuerzburg/), [Curanosticum Wiesbaden-Frankfurt](https://onco.cc/institutions/curanosticum/), [Erasmus MC Cancer Institute](https://onco.cc/institutions/erasmus-mc/), [European Association of Nuclear Medicine](https://onco.cc/institutions/eanm/), [Excel Diagnostics and Nuclear Oncology Center](https://onco.cc/institutions/excel-diagnostics-nuclear-oncology/), [Holden Comprehensive Cancer Center, University of Iowa](https://onco.cc/institutions/iowa-holden/), [Inselspital, Bern University Hospital / University Cancer Center Inselspital](https://onco.cc/institutions/inselspital-bern/), [International Atomic Energy Agency: Rays of Hope](https://onco.cc/institutions/iaea/), [IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)](https://onco.cc/institutions/irst-meldola/), [King Faisal Specialist Hospital and Research Centre](https://onco.cc/institutions/kfshrc/), [King Hussein Cancer Center](https://onco.cc/institutions/khcc/), [Movember](https://onco.cc/institutions/movember/), [Oslo University Hospital, The Norwegian Radium Hospital](https://onco.cc/institutions/oslo-radium-hospital/), [Peter MacCallum Cancer Centre](https://onco.cc/institutions/peter-mac/), [Postgraduate Institute of Medical Education and Research, Chandigarh](https://onco.cc/institutions/pgimer-chandigarh/), [Purdue Institute for Cancer Research](https://onco.cc/institutions/purdue-cancer-research/), [Sahlgrenska University Hospital / Sahlgrenska Center for Cancer Research](https://onco.cc/institutions/sahlgrenska/), [Society of Nuclear Medicine and Molecular Imaging](https://onco.cc/institutions/snmmi/), [Steve Biko Academic Hospital / University of Pretoria](https://onco.cc/institutions/steve-biko-academic-hospital/), [Therapeutic Goods Administration](https://onco.cc/institutions/tga/), [TUM Klinikum rechts der Isar / CCC München](https://onco.cc/institutions/tum-munich/), [University Hospital Basel / Tumour Centre](https://onco.cc/institutions/usb-basel/), [University Hospital Düsseldorf / CIO Düsseldorf](https://onco.cc/institutions/uk-duesseldorf/), [University Hospital Zurich / Comprehensive Cancer Center Zurich](https://onco.cc/institutions/usz-zurich/), [Uppsala University Hospital / Uppsala University](https://onco.cc/institutions/uppsala-akademiska/), [West German Cancer Center (WTZ), University Hospital Essen](https://onco.cc/institutions/essen-wtz/)
- pathways: [Drug efflux pumps (ABC transporters)](https://onco.cc/pathways/drug-efflux-pumps/), [Epithelial-mesenchymal transition & drug efflux](https://onco.cc/pathways/emt/), [Fibroblast activation, desmoplasia & matrix stiffness](https://onco.cc/pathways/caf-activation-desmoplasia/), [Resistance routes: how a blocked pathway comes back](https://onco.cc/pathways/resistance-routes-map/)
- terms: [Alpha vs beta emitters](https://onco.cc/terms/alpha-vs-beta/), [Cancer-associated fibroblasts (CAFs)](https://onco.cc/terms/cancer-associated-fibroblasts/), [Dosimetry](https://onco.cc/terms/dosimetry/), [Gray unit (Gy)](https://onco.cc/terms/gray-unit/), [Half-life](https://onco.cc/terms/half-life/), [Ligand](https://onco.cc/terms/ligand/), [PRRT (peptide receptor radionuclide therapy)](https://onco.cc/terms/prrt-term/), [Radiotherapy](https://onco.cc/terms/radiotherapy/), [Systemic versus local therapy](https://onco.cc/terms/systemic-vs-local-therapy/), [Theranostics](https://onco.cc/terms/theranostics/)
- pairings: [Beta radioligand → alpha radioligand](https://onco.cc/pairings/beta-then-alpha/), [PSMA PET → PSMA radioligand therapy](https://onco.cc/pairings/psma-pet-to-rlt/)
- roadmaps: [Radiopharmaceutical roadmap: iodine → lutetium → actinium](https://onco.cc/roadmaps/radiopharma-roadmap/)
- people: [A. Oliver Sartor](https://onco.cc/people/oliver-sartor/), [Ebrahim S. Delpassand](https://onco.cc/people/ebrahim-delpassand/), [Emily K. Bergsland](https://onco.cc/people/emily-bergsland/), [Jason S. Lewis](https://onco.cc/people/jason-lewis/), [Jeremie Calais](https://onco.cc/people/jeremie-calais/), [Johannes Czernin](https://onco.cc/people/johannes-czernin/), [Jonathan R. Strosberg](https://onco.cc/people/jonathan-strosberg/), [Katherine K. Matthay](https://onco.cc/people/katherine-matthay/), [Ken Herrmann](https://onco.cc/people/ken-herrmann/), [Louise Emmett](https://onco.cc/people/louise-emmett/), [Martin Schlumberger](https://onco.cc/people/martin-schlumberger/), [Michael Hofman](https://onco.cc/people/hofman-michael/), [Michael J. Morris](https://onco.cc/people/michael-morris/), [Peter Bartenstein](https://onco.cc/people/peter-bartenstein/), [Rahul Aggarwal](https://onco.cc/people/rahul-aggarwal/), [Richard P. Baum](https://onco.cc/people/richard-baum/), [Shahneen Sandhu](https://onco.cc/people/sandhu-shahneen/), [Simron Singh](https://onco.cc/people/simron-singh/), [Thomas A. Hope](https://onco.cc/people/thomas-hope/), [Uwe Haberkorn](https://onco.cc/people/uwe-haberkorn/), [Wolfgang A. Weber](https://onco.cc/people/wolfgang-weber/)
- bottlenecks: [Manufacturing cost and time for living and radioactive medicines](https://onco.cc/bottlenecks/b-manufacturing-cell-therapy/), [Wrong doses](https://onco.cc/bottlenecks/b-dose-optimisation/)

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