Lutathera (lutetium Lu 177 dotatate)

The aim of this work is to evaluate [89Zr]Zr-DFO-TATE and [89Zr]Zr-DFO-TOC for PET imaging of SSTR+ NETs. This study seeks to provide a comprehensive in vivo comparison of the two agents including the in vivo PET imaging, ex vivo biodistribution, and internal radiation dosimetry, with the overarching goal of advancing precision diagnostics and improving therapeutic planning for NET patients undergoing [177Lu]Lu-DOTA-TATE therapy.

The addition of everolimus, a mammalian target of rapamycin inhibitor, to octreotide marginally improves the 6-month progression-free survival (PFS) rate...We present the first case of a refractory meningioma patient treated with combination PRRT and octreotide in a 66-year-old male who received 177Lu-DOTATATE 7.4 GBq (200 mCi) and intramuscular long-acting octreotide 40 mg every 8 weeks for four cycles followed by a single cycle of octreotide 40 mg monotherapy...A 7-week post-treatment MRI brain demonstrated stable disease with 11.5% reduction per RANO-Meningioma and a 2.6% reduction per RECIST 1.1 criteria. Combined PRRT and octreotide represents a promising therapeutic strategy for patients with refractory meningioma.

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.

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.

P1, N=29, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Jun 2026 --> Dec 2026 | Trial primary completion date: Jun 2026 --> Dec 2026

SSTR expression in NEPC is heterogeneous. SSTR imaging can support phenotyping and selection for SSTR directed therapy in selected patients, including PSMA low disease, but prospective validation with standardized reporting is needed.

DOTATOC PET showed no uptake in the pancreatic lesion but revealed high uptake in the primary ASPS in scapula and previously unrecognized metastases in the breast and skull, indicating high somatostatin receptor (SSTR) expression. To our knowledge, this is the first report of DOTATOC uptake in ASPS, which raises the prospect of SSTR-targeted treatment with 177Lu-DOTATATE.

Hybrid PET/MRI improves hepatic lesion characterization and reduces radiation in appropriate patients, while CT/MRI remains indispensable for morphology and complications. Integrating multi-tracer PET with anatomic imaging refines risk stratification, PRRT selection, and longitudinal response assessment.

P2, N=10, Recruiting, OHSU Knight Cancer Institute | Not yet recruiting --> Recruiting | Trial completion date: Dec 2026 --> Dec 2027 | Trial primary completion date: Dec 2026 --> Dec 2027

P2, N=146, Recruiting, Institut du Cancer de Montpellier - Val d'Aurelle | Trial completion date: Oct 2031 --> Oct 2033 | Trial primary completion date: Oct 2031 --> Oct 2033