Lutathera (lutetium Lu 177 dotatate)

P1/2, N=19, Active, not recruiting, Melanoma and Skin Cancer Trials Limited | Recruiting --> Active, not recruiting | Trial completion date: Jul 2027 --> Dec 2027 | Trial primary completion date: Jul 2027 --> Dec 2026

Age and weight did not show a clinically significant impact on 177Lu-DOTATATE exposure or kidney and bone marrow dosimetry values, confirming that flat dosing at adult dosage is appropriate for adolescents. 177Lu-DOTATATE with 7.4 GBq of activity, administered over 4 cycles 8 wk apart, is a well-tolerated therapeutic dosing regimen for adolescent patients with gastroenteropancreatic neuroendocrine tumors or pheochromocytomas and paragangliomas.

P1, N=10, Recruiting, University of Wisconsin, Madison | Trial completion date: Mar 2026 --> Jun 2026 | Trial primary completion date: Mar 2026 --> Jun 2026

P2/3, N=160, Recruiting, Philipps-Universitaet Marburg | Not yet recruiting --> Recruiting

P1, N=65, Active, not recruiting, Novartis Pharmaceuticals | Trial primary completion date: Jun 2026 --> Dec 2025

In patients with radiologic progression requiring systemic disease control, targeted agents such as everolimus and sunitinib represent established subsequent options, particularly when disease stabilization is the primary therapeutic goal. Peptide receptor radionuclide therapy with 177Lu-DOTATATE has demonstrated meaningful antitumor activity and is generally considered in patients with SSTR-positive tumors with progressive disease (Ki-67 ≥ 10%) or increasing tumor burdens, especially when tumor reduction is desirable. Combination cytotoxic chemotherapy, most notably the capecitabine-temozolomide (CAPTEM) regimen, remains an important consideration for patients with higher tumor burdens or more aggressive tumor biology. This review summarizes current evidence and provides a practical overview of treatment selection and sequencing for the systemic management of Grade 1-2 pancreatic neuroendocrine tumors, while also highlighting emerging therapeutic strategies, including targeted alpha therapy and SSTR2 antagonist-based approaches.

P1, N=31, Active, not recruiting, Novartis Pharmaceuticals | Trial completion date: Jun 2027 --> Aug 2026 | Trial primary completion date: Jun 2027 --> Aug 2026

P2, N=32, Active, not recruiting, NYU Langone Health | Trial primary completion date: Jan 2026 --> Apr 2025

This Delphi consensus provides pragmatic, multidisciplinary, and evidence-informed guidance to harmonize routine clinical practice in the use of PRRT for well-differentiated, SSTR-positive NETs. The proposed statements and the algorithm aim to harmonize practice across centers, reduce variability in care, enhance safety, and ultimately improve patient outcomes.

We report a case of meningioma brain tumor becoming refractory after initial neurosurgery and stereotactic radiotherapy. Meningioma has progressed to lung metastases displaying high expression of SSTR, and hence suitable for PRRT.

P1, N=15, Recruiting, Emory University | Not yet recruiting --> Recruiting | Trial completion date: Sep 2026 --> Sep 2027 | Trial primary completion date: Sep 2025 --> Sep 2026

PRRT combined with everolimus-based immunosuppression has demonstrated controllable safety and preliminary antitumor activity in patients with relapsed NETLM after LT who have been strictly screened, but myelosuppression requires close monitoring and timely symptomatic treatment.