Title:Peptide Receptor Radionuclide Therapy: Looking Back, Looking Forward
Volume: 20
Issue: 32
Author(s): Danny Feijtel, Marion de Jong and Julie Nonnekens*
Affiliation:
- Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam,Netherlands
Keywords:
Peptide receptor radionuclide therapy (PRRT), Combination therapy, Neuroendocrine tumors (NET), Radiopharmaceuticals,
Radiobiology, Therapeutic effects.
Abstract: Peptide receptor radionuclide therapy (PRRT) is a highly effective anti-cancer treatment
modality for patients with non-resectable, metastasized neuroendocrine tumors (NETs). During PRRT,
specific receptors that are overexpressed on the cancer cells are targeted with a peptide labeled with a
DNA-damaging radionuclide. Even though PRRT is a powerful treatment for metastasized NET patients,
the majority still cannot be cured at this stage of the disease. Hence, many investigators focus on
improving the therapeutic efficacy of this therapy. Improving PRRT can, for example, be achieved by
using other radionuclides with different physical properties, by combining PRRT with radiosensitizing
agents or by radiolabeling peptides with different characteristics. However, due to lack of extensive
knowledge of radiobiological responses of cancer cells to PRRT, biological parameters that influence
absorbed dose or that might even elicit insensitivity to therapy remain elusive and the context in which
these improvements will be successful warrants further investigation. In this review, we will discuss the
development of PRRT, its clinical merits in current treatment and future perspectives. We will highlight
different radionuclides and their benefits and pitfalls, as well as different peptide-conjugates that hold
these radionuclides. We will zoom in on the latest developments regarding combinatorial treatments
and how investigators from different disciplines such as dosimetry and radiobiology are now joining
forces to improve PRRT for NETs.