Digestive Disease Interventions 2019; 03(01): 071-080
DOI: 10.1055/s-0038-1676064
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Peptide Receptor Radionuclide Therapy for Gastroenteropancreatic Neuroendocrine Tumors

Ghassan El-Haddad
1   Section Head of Radionuclide Therapy Program, Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
› Author Affiliations
Further Information

Publication History

19 September 2018

09 October 2018

Publication Date:
17 January 2019 (online)

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Abstract

Peptide receptor radionuclide therapy (PRRT), a targeted form of systemic radiotherapy allowing the delivery of radionuclides directly to tumor cells, has been used for more than three decades in the treatment of advanced neuroendocrine tumors (NETs) exhibiting high levels of somatostatin receptors. Recently, 177Lu-DOTATATE, a radiolabeled somatostatin analog, was approved by the US Food and Drug administration for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in adults. Early phase I and II studies have shown the benefits of PRRT, but it was the NETTER-1 trial (a large-scale randomized multicenter trial for progressive well-differentiated advanced or metastatic somatostatin receptor-positive midgut carcinoid tumors) that provided high-level evidence of improved overall response rate, and progression-free survival compared with long-acting octreotide. In this article, we will discuss the evolution, clinical applications, and implementation of PRRT, as well as potential future strategies to enhance its clinical efficacy in the treatment of GEP-NETs.