{"entity":{"id":"action-1","kind":"trial","name":"ACTION-1","aka":[],"tldr":"Tests whether an actinium alpha-radioligand rescues neuroendocrine tumours after lutetium therapy fails.","summary":"ACTION-1, trial NCT05477576 sponsored by Bristol Myers Squibb through RayzeBio, tests whether the actinium-225 alpha-radioligand RYZ101, or 225Ac-DOTATATE, rescues somatostatin-receptor-positive gastroenteropancreatic neuroendocrine tumours after lutetium-177 somatostatin analogue therapy has failed. Its phase 1b established a fixed dose of 10.2 MBq with encouraging responses, the phase 3 against investigator's choice is enrolling with an interim analysis expected in 2026, and its dosimetry was published in the Journal of Nuclear Medicine in 2026. OnCo links it to targeted alpha therapy, actinium-225 DOTATATE, lutetium-177 dotatate and the pairing of beta then alpha PRRT. Whether an alpha emitter can overcome resistance to a beta emitter aimed at the same receptor is the question it will answer.","status":"recruiting","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT05477576","url":"https://clinicaltrials.gov/study/NCT05477576"},{"label":"ACTION-1 dosimetry (JNM 2026)","url":"https://jnm.snmjournals.org/content/67/8/1239"}],"tags":[],"related":[],"cancers":["neuroendocrine"],"sections":[],"technologies":["targeted-alpha-therapy"],"targets":[],"drugs":["ryz101","lutathera"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT05477576","phase":"3","setting":"SSTR-positive GEP-NETs progressing after 177Lu somatostatin-analogue therapy: 225Ac-DOTATATE (RYZ101) vs investigator's choice","sponsor":"BMS (RayzeBio)","started":"2022-03-24","startedType":"actual","enrolledBasis":"registry","outcomes":[]},"route":"/trials/action-1/","neighbours":{"cancer":[{"id":"neuroendocrine","kind":"cancer","name":"Neuroendocrine tumours","route":"/cancers/neuroendocrine/"},{"id":"pancreatic-net","kind":"cancer","name":"Pancreatic neuroendocrine tumours","route":"/cancers/pancreatic-net/"},{"id":"small-intestinal-net","kind":"cancer","name":"Small intestinal neuroendocrine tumours","route":"/cancers/small-intestinal-net/"}],"technology":[{"id":"targeted-alpha-therapy","kind":"technology","name":"Targeted alpha therapy","route":"/technologies/targeted-alpha-therapy/"}],"drug":[{"id":"ryz101","kind":"drug","name":"Actinium-225 DOTATATE","route":"/drugs/ryz101/"},{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","route":"/drugs/lutathera/"}],"pairing":[{"id":"prrt-then-alpha-net","kind":"pairing","name":"Beta PRRT → alpha PRRT","route":"/pairings/prrt-then-alpha-net/"}]}}