PRRT with 177Lu-DOTATATE was FDA approved in 2018 for the treatment of gastroenteropancreatic neuroendocrine tumors. There are ongoing clinical trials featuring other radiopharmaceuticals, isotopes, peptides and combinations with other therapy.
What conditions are treated with PRRT?
PRRT is used to treat NETs,
Who have advanced (metastatic) and/or progressive (e.g. to SSA) neuroendocrine tumors positive on somatostatin receptor imaging (e.g. 68Ga-DOTATATE/NETSPOT or 64Cu Dotatate/Detecnet) which are radioactive tracers used with PET/CT or PET/MR machines.
Who are not candidates for surgery
Whose symptoms do not respond to other medical therapies
Benefits of PRRT include symptom relief, slowing tumor progression and improving overall survival.
The administration of the PRRT itself is well tolerated, but patients may experience nausea and vomiting as a result of the amino acid solution given for kidney protection, especially with some types of amino acid solutions. This is managed with anti-nausea medication or slowing down the administration of the amino acids. Long-term side effects can include a suppression of blood cell counts, which is mild to moderate in the majority of cases. Delayed side effects, such as permanent kidney injury, or the appearance of secondary blood disorders (called myelodysplastic syndrome), are rare. Overall, the treatment is well tolerated by most patients.
Home Care
Your medical facility will provide you with instructions for special care to be taken following treatment. Because small amounts of radiation temporarily remain in the body, patients need to follow the radiation safety protocol provided by your facility. This may include staying a safe distance from others for several days and careful hygiene following PRRT therapy. Because the radioactive drug is removed from the body mainly through the urine and feces, it is important to maintain good bathroom hygiene during this period.
My first PRRT:
