{"entity":{"id":"prrt-then-alpha-net","kind":"pairing","name":"Beta PRRT → alpha PRRT","aka":[],"tldr":"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.","asOf":"2026-09-07","links":[{"label":"ClinicalTrials.gov NCT05153772: ALPHAMEDIX-02","url":"https://clinicaltrials.gov/study/NCT05153772"},{"label":"ClinicalTrials.gov NCT05477576: ACTION-1","url":"https://clinicaltrials.gov/study/NCT05477576"}],"tags":[],"related":[],"cancers":["neuroendocrine"],"sections":[],"technologies":["targeted-alpha-therapy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["alpha-vs-beta"],"trials":["alphamedix-02","action-1"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"a":"lutathera","b":"alphamedix","rationale":"Alpha particles deliver oxygen-independent clustered DNA damage that beta-resistant clones cannot repair.","evidence":"Phase 2 (AlphaMedix); phase 3 pending (ACTION-1).","pairingType":"sequence"},"route":"/pairings/prrt-then-alpha-net/","neighbours":{"cancer":[{"id":"neuroendocrine","kind":"cancer","name":"Neuroendocrine tumours","route":"/cancers/neuroendocrine/"}],"technology":[{"id":"targeted-alpha-therapy","kind":"technology","name":"Targeted alpha therapy","route":"/technologies/targeted-alpha-therapy/"}],"term":[{"id":"alpha-vs-beta","kind":"term","name":"Alpha vs beta emitters","route":"/terms/alpha-vs-beta/"}],"trial":[{"id":"action-1","kind":"trial","name":"ACTION-1","route":"/trials/action-1/"},{"id":"alphamedix-02","kind":"trial","name":"ALPHAMEDIX-02","route":"/trials/alphamedix-02/"}],"drug":[{"id":"alphamedix","kind":"drug","name":"212Pb-DOTAMTATE","route":"/drugs/alphamedix/"},{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","route":"/drugs/lutathera/"}]}}