177Lu-DOTA therapy – 100 mCi
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177Lu-DOTA therapy – 100 mCi
₹200000
177Lu-DOTA Therapy, also known as Peptide Receptor Radionuclide Therapy (PRRT), is a targeted molecular therapy designed to treat neuroendocrine tumours (NETs) that originate from organs such as the gastrointestinal tract, lungs, pancreas, and thymus, and have spread throughout the body. Administered in a safe and measured dose—typically 100 mCi per cycle—this therapy offers a new avenue of treatment for patients with advanced, inoperable, or treatment-resistant NETs. Unlike traditional chemotherapy or radiation therapy that affects both healthy and cancerous cells, 177Lu-DOTA therapy delivers radiation directly to tumour cells that express somatostatin receptors (SSTR). This precision reduces side effects and enhances therapeutic outcomes, making it an ideal choice for well-differentiated, SSTR-positive neuroendocrine tumours.
What is 177Lu-DOTA Therapy?
177Lu-DOTA therapy uses a radioactive isotope, Lutetium-177, bound to a somatostatin analogue such as DOTA-TATE, DOTA-NOC, or DOTA-TOC. These molecules selectively bind to somatostatin receptors, which are commonly overexpressed on NET cells. Once injected into the bloodstream, the radiolabeled compound locates and binds to these receptors, delivering localized radiation to the tumor while sparing surrounding healthy tissues. The radiation damages the DNA of cancer cells, halting their replication and inducing cell death, resulting in shrinkage or stabilization of the tumour.
Indications for 177Lu-DOTA Therapy (PRRT)
177Lu-DOTA therapy is typically recommended for:
- • Metastatic or inoperable neuroendocrine tumours
- • NETs expressing somatostatin receptors, confirmed by 68Ga-DOTA PET-CT
- • Recurrent NETs not responding to conventional treatments
- • Pancreatic NETs, gastrointestinal NETs, bronchial NETs, and other SSTR-positive tumours
- • Patients with progressive disease despite prior therapy
This therapy is particularly useful in slowing disease progression, improving quality of life, and in some cases, leading to partial or complete tumour response.
Therapy Schedule and Dosage
177Lu-DOTA therapy is typically administered in 3 to 5 cycles, with each cycle spaced 6 to 12 weeks apart, depending on the patient's clinical status, organ function, and tumour response.
Each cycle usually consists of a 100 mCi dose of 177Lu-DOTA compound infused intravenously. The therapy is performed under medical supervision in a nuclear medicine department equipped with radiation safety infrastructure.
Pre-Therapy Assessment
Before the first cycle, patients undergo thorough evaluation:
• 68Ga-DOTA PET-CT scan to confirm somatostatin receptor positivity
• Kidney and liver function tests to ensure safe excretion of the radiotracer
• Complete blood counts to evaluate bone marrow reserves
• Baseline tumour markers and symptom assessments
• Review of prior treatments and current medications
Only patients who meet the eligibility criteria are recommended for PRRT.
Procedure of 177Lu-DOTA Therapy
The treatment process is simple and well tolerated:
- Patient admission and pre-medication (anti-nausea drugs if needed)
- Amino acid infusion started prior to 177Lu-DOTA to protect the kidneys
- Slow intravenous infusion of 100 mCi of 177Lu-DOTA over 30–60 minutes
- Monitoring of vital signs during and after the infusion
- Radiation safety protocols followed to minimize exposure to others
Most patients are discharged the same day or within 24 hours. Radiation exposure is limited and typically does not require long hospital stays.
Post-Therapy Monitoring and Follow-up
After each cycle, the following evaluations are carried out:
• Blood tests to assess kidney, liver, and bone marrow function
• Tumour marker tests like Chromogranin A
• Follow-up imaging (PET-CT or MRI) to evaluate tumour response
• Symptom tracking (pain, fatigue, appetite, etc.)
• Assessment of quality of life and functional status
If the patient responds well and tolerates the treatment, the next cycle is scheduled within 6–12 weeks.
Benefits of 177Lu-DOTA Therapy
• High specificity – Targets only somatostatin receptor-positive tumour cells
• Low toxicity – Minimal damage to healthy tissues
• Outpatient-friendly – Most cases require no overnight hospital stay
• Improves symptoms like abdominal pain, flushing, and diarrhea
• Slows disease progression and improves overall survival in many cases
• Alternative to chemotherapy for patients with poor tolerance to cytotoxic agents
• Safe and repeatable, up to 5 cycles in suitable candidates
Potential Side Effects
Though generally well tolerated, some patients may experience:
• Mild nausea, fatigue, or abdominal discomfort
• Temporary drop in blood cell counts (anemia, leukopenia)
• Kidney function alterations (hence amino acid protection is essential)
• Dry mouth or metallic taste
• Very rare cases of bone marrow suppression or liver injury
These side effects are closely monitored, and most are manageable with supportive care.
Who Should Avoid PRRT?
177Lu-DOTA therapy may not be suitable for:
- Patients with severely impaired kidney or liver function
- Those with poor bone marrow reserves
- Patients with non-receptor expressing tumours (negative PET scan)
- Pregnant or breastfeeding women
Eligibility is determined through a comprehensive medical assessment.
Conclusion
177Lu-DOTA Therapy – 100 mCi offers a highly effective, targeted treatment for patients with advanced neuroendocrine tumours, especially those who are not candidates for surgery or have not responded to conventional therapies. With its ability to deliver focused radiation to tumour cells while preserving healthy tissue, PRRT is a game-changing advancement in nuclear medicine. It improves both tumour control and quality of life in suitable candidates and is now a cornerstone in the treatment of metastatic NETs. The structured dosing, minimal invasiveness, and strong safety profile make it a reliable and preferred option in many nuclear medicine centers worldwide. If you or a loved one is diagnosed with a neuroendocrine tumour, consult your oncologist or nuclear medicine specialist to explore if 177Lu-DOTA Therapy is the right path forward.
Test information: Fasting: 2 hours
Reporting: Not applicable
- Some medications, such as Somatostatin analogues, may interfere with this treatment. The long-acting medicines may need to withdraw for 4-6 weeks, and short-acting may need to stop for 24 hours. Kindly ensure this in consultation with your doctor.
- In pre-work up, blood tests such as complete blood count (CBC), liver and kidney function tests (LFT, KFT), and serum electrolytes are carried out before each treatment cycle and at follow-up visits.
- 68Ga-DOTANOC PET/CT scan is done before the treatment and after the completion of each two cycles of 177Lu-DOTA therapy, and after the entire treatment.
- CBC, LFT, and KFT tests are performed every 8–12 weeks for the first 12 months and twice a year if clinically indicated.
- During the first 2 days after PRRT, the high activity level is excreted. Patients are advised to avoid contamination of toilets and flush the toilet twice. Patients should wash their hands after urination.
- Patients should avoid soiling underclothing or areas around toilet bowls for 1 week following PRRT. Considerably contaminated clothing should be washed separately.
- Incontinent patients should be catheterized before PRRT, and the catheter should be kept for 2 days after that. Urine bags should be emptied frequently.
- Gloves and protective clothing should be worn by the person caring for catheterized patients (or providing any care involving close contact).
- Women of childbearing age should avoid pregnancy for at least 6 months. Male patients should consider sperm banking before therapy.
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