Peptide receptor radionuclide therapy in neuroendocrine tumours: advances, combination strategies, and future

Related Experiment Video

Updated: Feb 15, 2026

A Whole Body Dosimetry Protocol for Peptide-Receptor Radionuclide Therapy PRRT: 2D Planar Image and Hybrid 2D+3D SPECT/CT Image Methods
09:49

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

10.5K

Irene J Virgolini1, Gianpaolo Di Santo2, Giulia Santo2

  • 1¹Department of Nuclear Medicine, Medical University of Innsbruck, Anichstraße 35, Innsbruck, 6020, Austria. irene.virgolini@i-med.ac.at.

European Journal of Nuclear Medicine and Molecular Imaging
|February 14, 2026
PubMed

Insights

Peptide receptor radionuclide therapy (PRRT) is a key treatment for advanced neuroendocrine tumors (NETs). Recent trials support its use in more NETs, with new therapies like alpha-emitters and combination strategies showing promise.

Area of Science:

  • Nuclear oncology
  • Radiopharmaceutical chemistry
  • Medical oncology

Background:

  • Peptide receptor radionuclide therapy (PRRT) is crucial for advanced somatostatin receptor (SSTR)-positive neuroendocrine tumors (NETs).
  • The NETTER-1 trial confirmed [177Lu]Lu-DOTATATE efficacy in midgut NETs, leading to regulatory approvals.
  • The NETTER-2 trial supports first-line PRRT for Grade 2 and 3 gastroentero-pancreatic (GEP)-NETs.

Purpose of the Study:

  • To review the clinical evidence, translational advances, and future directions of PRRT in neuroendocrine tumor management.
  • To highlight emerging developments including SSTR antagonists, alpha-particle therapies, and combination strategies.
  • To discuss novel peptide ligands and theragnostic approaches for personalized NETs treatment.

Main Methods:

  • Summary of clinical trial data (NETTER-1, NETTER-2) on PRRT efficacy and safety.
  • Review of recent advancements in radiopharmaceutical chemistry and targeted therapies.
  • Analysis of ongoing research in combination strategies and novel theragnostic ligands.

Main Results:

  • PRRT with [177Lu]Lu-DOTATATE significantly improves progression-free survival and quality of life in specific NET populations.
  • Emerging therapies like SSTR antagonists and alpha-emitters show potential for resistant or rare NETs.
  • New peptide ligands (e.g., CCK2R-targeted) offer promise for conditions like medullary thyroid carcinoma and small-cell lung cancer.

Conclusions:

  • PRRT is a cornerstone of precision nuclear oncology for NETs.
  • Expanding indications, integrating alpha-emitters, and optimizing safety are key future directions.
  • Development of novel theragnostic ligands will enable personalized treatment strategies for NET patients.
Keywords:
CCK2 receptorCombination therapyNeuroendocrine tumourPeptide receptor radionuclide therapySSTR antagonistTargeted alpha therapy

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