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Updated: Dec 27, 2025
A Whole Body Dosimetry Protocol for Peptide-Receptor Radionuclide Therapy PRRT: 2D Planar Image and Hybrid 2D+3D SPECT/CT Image Methods
Published on: April 24, 2020
Peptide Receptor Radionuclide Therapy: Looking Back, Looking Forward
Danny Feijtel1, Marion de Jong1, Julie Nonnekens1
1Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, Netherlands.
Abstract:
Peptide receptor radionuclide therapy (PRRT) is a highly effective anti-cancer treatment modality for patients with non-resectable, metastasized neuroendocrine tumors (NETs). During PRRT, specific receptors that are overexpressed on the cancer cells are targeted with a peptide labeled with a DNA-damaging radionuclide. Even though PRRT is a powerful treatment for metastasized NET patients, the majority still cannot be cured at this stage of the disease. Hence, many investigators focus on improving the therapeutic efficacy of this therapy. Improving PRRT can, for example, be achieved by using other radionuclides with different physical properties, by combining PRRT with radiosensitizing agents or by radiolabeling peptides with different characteristics. However, due to lack of extensive knowledge of radiobiological responses of cancer cells to PRRT, biological parameters that influence absorbed dose or that might even elicit insensitivity to therapy remain elusive and the context in which these improvements will be successful warrants further investigation. In this review, we will discuss the development of PRRT, its clinical merits in current treatment and future perspectives. We will highlight different radionuclides and their benefits and pitfalls, as well as different peptide-conjugates that hold these radionuclides. We will zoom in on the latest developments regarding combinatorial treatments and how investigators from different disciplines such as dosimetry and radiobiology are now joining forces to improve PRRT for NETs.
Insights
Peptide receptor radionuclide therapy (PRRT) effectively treats advanced neuroendocrine tumors (NETs). Further research into radiobiology and dosimetry is crucial for enhancing PRRT efficacy and patient outcomes.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiochemistry
Background:
- Peptide receptor radionuclide therapy (PRRT) is a key treatment for metastatic neuroendocrine tumors (NETs).
- Despite its effectiveness, PRRT does not cure all patients, necessitating research into improved therapeutic strategies.
- Understanding the radiobiological response of cancer cells to PRRT is essential for optimizing treatment outcomes.
Purpose of the Study:
- To review the development and clinical applications of PRRT for neuroendocrine tumors.
- To explore strategies for enhancing PRRT efficacy, including novel radionuclides and peptide conjugates.
- To highlight the importance of interdisciplinary collaboration in advancing PRRT.
Main Methods:
- Review of existing literature on PRRT development, clinical outcomes, and emerging research.
- Analysis of different radionuclides and peptide-conjugates used in PRRT.
- Discussion of combinatorial treatment approaches and the role of dosimetry and radiobiology.
Main Results:
- PRRT is a valuable treatment for metastatic NETs, but complete cure rates remain limited.
- Various radionuclides and peptide-conjugates offer different therapeutic profiles and challenges.
- Combinatorial treatments and improved understanding of radiobiology show promise for enhancing PRRT efficacy.
Conclusions:
- PRRT has significantly advanced NET treatment, but further optimization is needed.
- Future improvements in PRRT will likely involve tailored radionuclide selection, novel peptide targeting, and combination therapies.
- Integrating dosimetry and radiobiology insights is critical for maximizing PRRT benefits in neuroendocrine tumor management.
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