Summary (10 sec read)

Peptide Receptor Radionuclide Therapy (PRRT) is a nuclear medicine treatment for Neuroendocrine Tumors (NETs) used worldwide. PRRT involves combining a cell-targeting protein, or peptide, with a radioactive material to create a radiopeptide. This radiopeptide is injected into the patient's bloodstream, where it targets NET cells that have somatostatin receptors, unlike healthy cells. The radiopeptide binds to these receptors and emits radiation to kill the tumor cells.

The treatment process involves creating a peptide that binds to tumor cell receptors, pairing it with a radioactive atom using a chelator, and injecting this radiopeptide into the bloodstream. The radiopeptide locates and binds to the NET cancer cells, delivering a lethal dose of radiation.

Patients typically undergo 4-6 PRRT sessions, spaced 2-3 months apart, as outpatient procedures. Clinical trials have demonstrated that PRRT can increase progression-free survival, improve quality of life, relieve symptoms, and reduce tumor size. While generally well-tolerated, PRRT can cause side effects such as nausea, vomiting, abdominal pain, and fatigue. Rare side effects include bone, liver, and kidney toxicity, and mild hair loss.

Nuclear Medicine, as a treatment protocol for Neuroendocrine Tumors (NETs) has been used in many countries across the globe for many a years.

PRRT or Peptide Receptor Radionuclide Therapy is a type of Nuclear Medicine Therapy in which a cell-targeting protein or peptide is combined with a small amount of radioactive material that created a special type of radiopharmaceutical known as a Radiopeptide. This radiopeptide is injected into a Neuroendocrine Tumor patient’s bloodstream.

Unlike healthy cells, the neuroendocrine tumor cells or NET cells have proteins on their cell surface. These proteins, also known as receptors, bind themselves to hormones, such as somatostatin. Peptide Receptor Radionuclide Therapy or PRRT with lutetium 177 dotatate or Lu177 targets these receptors with radiopeptides and deliver a high dose of radiation to the tumor cells.

How PRRT for NET works? – Method of Action
  1. A peptide i.e. a group of amino acids is created that can bind to the receptors on the tumor cell’s surface.
  2. This peptide is then paired with a radioactive atom using a chelator (a bonding agent).
  3. This combination of the peptide and the radioactive material creates a radiopeptide.
  4. This radiopeptide is injected into a Neurodendocrine Tumor (NET) patient’s bloodstream.
  5. The radiopeptide finds the NET cancer cell’s somatostatin receptors and binds itself to them.
  6. The radiopeptide emits radiation that kills the NET cancer cell.
Benefits of PRRT

Depending on the type of cancer being treated, patients may need to undergo up to 10 PRRT sessions. Usually, there would be around four-six sessions and these sessions are spaced two-three months apart. In most cases, this procedure is done as an outpatient procedure.

Several studies and clinical trials have shown that PRRT can…

  • Increase progression-free survival and in many cases likely survival.
  • Improve the quality of life.
  • Relieve symptoms.
  • Decrease tumor size.

While PRRT is generally well-tolerated, there occur some common side-effects, such as nausea, vomiting, abdominal pain and fatigue. Some very rare side-effects are bone, liver & kidney toxicity and mild hair loss.

Also Read: Which Patient can Benefit with PRRT

For more information on how PRRT can help, please call Dr. Ishita Sen, Director & Head, Department of Nuclear Medicine & Molecular Imaging, Fortis Memorial Research Institute (FMRI)on +91 9811 12 7080, or send an email to