Radioligand therapy (beta emitters)
A drug that finds tumour cells and carries a radioactive atom that irradiates them from inside the body.
177Lu-DOTATATE (Lutathera, 2018) in neuroendocrine tumours and 177Lu-PSMA-617 (Pluvicto, 2022; pre-chemotherapy label 2025; 2026 label expansion) in prostate cancer are the approved beta-emitter therapies. Pipeline: 177Lu-FAP, 177Lu-PSMA-I&T, 177Lu-NeoB (GRPR), 177Lu-labelled antibodies. Dosimetry-guided personalised dosing is emerging.
How it works
177Lu emits beta particles with ~2 mm range and gamma photons for SPECT imaging; the ligand determines biodistribution.
- Systemic, whole-body targeting of microscopic disease
- Crossfire kills antigen-negative neighbours
- Imaging companion selects patients
- Marrow and kidney dose
- Isotope logistics (6.7-day half-life)
- Not curative alone
High-dose radioactive MIBG delivers radiation from inside neuroblastoma cells that take up noradrenaline; used for relapsed disease and tested in upfront therapy.
A second lutetium radioligand for neuroendocrine tumours that beat the standard pill everolimus in a head-to-head trial and is awaiting an FDA decision.
177Lu-PSMA-I&T is a second PSMA radioligand, chemically different from Pluvicto, that has passed two phase 3 trials on progression but has not yet shown a survival benefit.
A FAP-targeted theranostic pair: one version images almost any solid tumour, the other treats it with radiation.
The PET scan for neuroendocrine tumours that finds far more disease than older scans and confirms eligibility for lutetium radioligand therapy (the theranostic pair).
Lutetium-177 dotatate was the first modern radioligand therapy (2018), for neuroendocrine tumours, and is now used in first line.
A radioactive drug that seeks out PSMA on prostate cancer cells; the best-selling radiopharmaceutical ever.
The original targeted radiotherapy: thyroid cells soak up iodine, so radioactive iodine destroys leftover thyroid tissue and metastases while sparing everything else.
Patients newly diagnosed with an advanced grade 2 or 3 neuroendocrine tumour of the gut or pancreas that shows somatostatin receptors on imaging can now receive lutetium dotatate as their first treatment, gaining more than a year of additional disease control and a much higher chance of tumour shrinkage. It does not settle whether radioligand therapy is better than other first-line options such as capecitabine-temozolomide or everolimus, and long-term marrow safety with earlier use needs surveillance.
Men with metastatic castration-resistant prostate cancer that has progressed after hormonal therapy and chemotherapy, and whose tumours show PSMA on a PET scan, can now receive lutetium-PSMA, which extends life, controls pain and is usually better tolerated than further chemotherapy. It has established a new treatment class in which a scan decides who gets the matching radioactive drug, and it is now being tested earlier in the disease (PSMAfore, PSMAddition).
Latest papers
topQuery for this technology: (TITLE:"radioligand therapy" OR ABSTRACT:"radioligand therapy" OR TITLE:"peptide receptor radionuclide therapy" OR ABSTRACT:"peptide receptor radionuclide therapy" OR TITLE:"lutetium-177" OR ABSTRACT:"lutetium-177" OR TITLE:"177Lu" OR ABSTRACT:"177Lu"). Results are unfiltered search hits about Radioligand therapy (beta emitters), not a curated reading list.
Pages like this
not linked directly; found by shared links- TechnologyFAPI PET
Shares Cancer-associated fibroblasts (CAFs), FAP theranostics as a pan-cancer stromal strategy, All India Institute of Medical Sciences, New Delhi, Postgraduate Institute of Medical Education and Research, Chandigarh.
- TechnologyPET/CT
Shares Nuclear medicine and total-body PET hardware, Gallium-68 DOTATATE (and Cu-64 DOTATATE), Total-body PET for personalised radioligand dosing, King Hussein Cancer Center.
- CompanyNovartis
Shares Build Western ytterbium-176 enrichment so lutetium-177 has more than one supplier, Purdue Institute for Cancer Research, Gallium-68 DOTATATE (and Cu-64 DOTATATE), University Hospital Basel / Tumour Centre.
- CompanyITM Isotope Technologies Munich
Shares Build Western ytterbium-176 enrichment so lutetium-177 has more than one supplier, 177Lu-edotreotide, Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225), Peptide receptor radionuclide therapy (PRRT).
- TechnologyPET (positron emission tomography)
Shares GRPR (gastrin-releasing peptide receptor), Thomas A. Hope, Johannes Czernin, MIBG imaging and 131I-MIBG therapy.
- ProductActinium-225 PSMA agents
Shares Recover legacy radium-226 sources worldwide as the feedstock for actinium-225, Alpha-emitting PSMA therapy at first metastatic diagnosis, Beta radioligand → alpha radioligand, Radiopharmaceutical roadmap: iodine → lutetium → actinium.
- CompanyOrano Med
Shares Recover legacy radium-226 sources worldwide as the feedstock for actinium-225, Therapeutic isotope supply chain (Mo-99, Lu-177, Ac-225), Peptide receptor radionuclide therapy (PRRT), Radiopharmaceutical roadmap: iodine → lutetium → actinium.
- InstitutionHeidelberg University Hospital / NCT / DKFZ
Shares Uwe Haberkorn, University Hospital Düsseldorf / CIO Düsseldorf, A university cyclotron network with shared regulatory files for new tracers, European Association of Nuclear Medicine.