Peptide Receptor Radionuclide Therapy of Neuroendocrine Tumors

Peptide receptor radionuclide therapy (PRRT) has been a well-accepted and effective therapeutic modality for inoperable or metastatic gastroenteropancreatic, bronchopulmonary and other neuroendocrine tumors for almost 2 decades. In general, PRRT is well tolerated with moderate toxicity in the majority of patients if the necessary precautions, appropriate dosage and coadministration of amino acids are undertaken. The two most commonly used radiopeptides, (90)Y-octreotide and (177)Lu-octreotate, produce significant objective response rates, with impact on progression-free survival and overall survival. In addition, biochemical and symptomatic responses are commonly observed. A key issue is the need to establish randomized controlled trials to standardize the treatment and facilitate comparison with other therapeutic strategies available.