P1, N=4, Completed, University of Wisconsin, Madison | Recruiting --> Completed | N=10 --> 4

This case demonstrates that emergency surgery can be performed safely during the early phase after PRRT when appropriate radiation safety precautions are implemented. Radiation exposure to surgical staff remained minimal at typical working distances, and even near-field exposure was within acceptable limits. Urgent surgical intervention should not be unnecessarily delayed following PRRT when clinically indicated, provided that appropriate monitoring and precautions are in place.

Combined PRRT with 225Ac/177Lu-DOTATATE appears feasible and potentially beneficial option in advanced meningiomas. However, given the small sample size, treatment heterogeneity, and lack of controlled comparison, the findings should be interpreted with caution. Larger prospective studies are warranted.

P2, N=78, Not yet recruiting, Sirtex Medical

P2, N=162, Active, not recruiting, Australian and New Zealand Urogenital and Prostate Cancer Trials Group | Trial completion date: Jan 2025 --> Dec 2026

P1, N=10, Recruiting, VitsGen Therapeutics Inc.

Our study suggests that tumor-specific CD8+T cells need to be present and activated prior to RPT to enhance antitumor outcomes. This study highlights the importance of considering the effects of RPT on tumor-infiltrating CD8+T cells when combining other T-cell activating therapies with RPT, as they may similarly display sequence-dependent antitumor outcomes.

P2, N=20, Not yet recruiting, Second Affiliated Hospital of Guangzhou Medical University

These findings support a front-loaded 177Lu-DOTATATE strategy to maximise tumour irradiation while maintaining exposure to risk organs within safety limits. Accordingly, the LuDO-N protocol has been amended to increase administered activity to 400 MBq/kg in the first fraction for subsequent patients. Together, this work contributes to the ongoing optimisation of dosimetry-guided and intensified treatment strategies for SSTR-targeted molecular radiotherapy for high-risk neuroblastoma.

P2, N=202, Not yet recruiting, Mayo Clinic

P3, N=1524, Recruiting, Alliance for Clinical Trials in Oncology | Not yet recruiting --> Recruiting | Initiation date: Oct 2025 --> Mar 2026

[177Lu]-Lu-6 showed superior tumor retention (13% uptake) and internalization (3.5%) compared to [177Lu]-Lu-FAP-2286/N188, with sustained tumor growth suppression in xenograft models. PET/SPECT imaging revealed high tumor-to-background ratios and favorable pharmacokinetics, highlighting the potential of these agents for clinical application.