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Neuroendocrine Tumours (NET)

PRRT with 177Lu-DOTATATE

I have been working with radionuclide therapy for neuroendocrine tumors for more than 20 years and have personally been involved in more than 1,000 treatments with ¹⁷⁷Lu-DOTATATE. My clinical and scientific work in this field began at the LMU Munich and continued at the University Hospital Vienna, where I was responsible for large radionuclide therapy units and the care of patients with neuroendocrine tumors.

The decision depends on the biology and extent of the disease, somatostatin receptor imaging, previous treatments, renal and bone marrow function and the overall clinical situation

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Is PRRT appropriate for your individual situation?

The decision to proceed with PRRT is more complex than simply demonstrating uptake on a somatostatin receptor PET scan.

Important factors include:

  • the origin and biological characteristics of the tumor

  • tumor grade and disease progression

  • the extent and distribution of metastatic disease

  • somatostatin receptor expression on PET/CT

  • previous systemic and local treatments

  • renal and bone marrow function

  • the patient’s general condition and treatment goals

A detailed assessment of these factors helps determine whether PRRT is appropriate and when it should be used in the individual course of the disease.

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¹⁷⁷Lu-DOTATATE PRRT

¹⁷⁷Lu-DOTATATE combines a somatostatin analogue with the therapeutic radionuclide lutetium-177. The treatment delivers radiation selectively to somatostatin receptor-positive tumor tissue.

For appropriately selected patients, PRRT can provide meaningful disease control and is an established treatment option for advanced neuroendocrine tumors.

However, not every patient with a positive somatostatin receptor PET scan will necessarily benefit to the same extent. The overall clinical context remains essential.

What if the disease progresses after PRRT?

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Progression after ¹⁷⁷Lu-DOTATATE does not automatically mean that all radionuclide therapy options have been exhausted.

Depending on the pattern and pace of progression, the degree of receptor expression, previous response and available alternatives, different strategies may be considered. These can include further systemic treatment, selected repeat PRRT or, in carefully selected cases, treatment with an alpha-emitting radionuclide such as ²²⁵Ac-DOTATATE.

Alpha therapy is a promising area of development, but the clinical evidence is currently less mature than for established ¹⁷⁷Lu-DOTATATE PRRT. I therefore consider its use on an individual basis rather than as a routine next step for every patient.

International patients

Patients from outside Austria can have their medical records and imaging reviewed before travelling to Vienna.

I can assess previous PET/CT examinations, pathology reports and treatment history and discuss whether radionuclide therapy appears appropriate, which treatment strategy may be reasonable, and what alternatives should be considered.

If treatment is indicated, radionuclide therapy can be provided in Vienna.

The purpose of the consultation is not simply to determine whether a patient can receive PRRT, but to answer the more important question:

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Is radionuclide therapy the right treatment for this patient at this point in the course of the disease?

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Experience and scientific background

  • 20+ years of experience in radionuclide therapy

  • 1,000+ ¹⁷⁷Lu-DOTATATE treatments

  • 160+ scientific publications

  • Clinical experience at major university hospitals in Germany and Austria

  • Longstanding clinical and scientific focus on neuroendocrine tumors and theranostics

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For an individual assessment of your case, please contact my office with your relevant medical records and imaging.

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e-mail: kontakt@dr-haug.at

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