[Current Status and Future Perspectives of Peptide Receptor Radionuclide Therapy in Neuroendocrine Tumors]

Peptide receptor radionuclide therapy(PRRT)using 177Lu-DOTATATE has become a well-established treatment option for patients with somatostatin receptor-positive neuroendocrine tumors(NET). The results of randomized controlled phase Ⅲ trials have demonstrated the high efficacy and low incidence of adverse events associated with PRRT, leading to a growing importance of PRRT in treatment strategies. In particular, NETTER-2 trial showed the efficacy and safety of first-line PRRT in G2-3 NET(10%≤Ki-67≤55%). However, in Japan, challenges remain in performing positron emission tomography as somatostatin receptor imaging, re-treatment for disease progression after PRRT, and post-PRRT imaging for personalized dosimetry due to limitations in coverage of public health insurance. Meanwhile, new radiopharmaceuticals utilizing different somatostatin analogs or α-emitting radionuclides are being investigated, with expectations for future clinical application. This article describes the current status, challenges, and future prospects of PRRT for NET.