Peptide Radiation Therapy for Neuroendocrine Tumors That Return After Liver Transplant | Research

The takeaway

Lu-177-DOTATATE peptide receptor radionuclide therapy shows promise for treating recurrent neuroendocrine tumor liver metastases after liver transplantation, even under immunosuppression.

7 post-transplant patients treated
PRRT shown feasible under everolimus immunosuppression for recurrent liver metastases

What the researchers found

Lu-177-DOTATATE PRRT demonstrated manageable toxicity and efficacy in 7 patients with recurrent neuroendocrine tumor liver metastases post-liver transplantation while on everolimus immunosuppression.

Why it matters

Patients whose neuroendocrine tumors recur after liver transplantation have extremely limited treatment options. PRRT could offer a viable salvage therapy for this vulnerable population.

How the study worked

Retrospective case series of 7 patients treated with PRRT for recurrent NETLM after liver transplantation.

What this study cannot tell us

Very small case series (n=7); retrospective design; no control group; long-term outcomes limited by small numbers and follow-up duration.

How to read the evidence

Small retrospective case series — provides proof of feasibility but insufficient for definitive efficacy conclusions.

When this study was published

Published in 2026, expanding the evidence base for PRRT in complex clinical scenarios.

The bigger picture

This extends peptide receptor radionuclide therapy to one of the most complex clinical scenarios — post-transplant cancer recurrence — where the interplay between anti-cancer treatment and immunosuppression is critical.

Questions still open

Does everolimus immunosuppression affect PRRT efficacy through its own anti-tumor properties?
What is the optimal PRRT protocol for post-transplant patients balancing tumor control and organ preservation?

Common questions

What is peptide receptor radionuclide therapy?

PRRT uses radioactive peptides that bind to specific receptors on tumor cells, delivering targeted radiation directly to the cancer. Lu-177-DOTATATE targets somatostatin receptors commonly found on neuroendocrine tumors.

Can cancer come back after a liver transplant?

Yes — neuroendocrine tumor metastases can recur even after complete liver transplantation. This is particularly challenging because patients need immunosuppression to prevent organ rejection, which can limit cancer treatment options.

Read the original research

Peptide Receptor Radionuclide Therapy for Recurrent Neuroendocrine Tumor Liver Metastases After Liver transplantation: A Case Series.

Transplantation proceedings

View on PubMed ↗Publisher’s paper ↗

Citation

Chen, Chiyi; Zheng, Qiming; Zhang, Li; Guo, Qingjun; Wang, Honghai; Sun, Jisan; Xie, Yan; Jiang, Wentao. (2026). Peptide Receptor Radionuclide Therapy for Recurrent Neuroendocrine Tumor Liver Metastases After Liver transplantation: A Case Series.. Transplantation proceedings. https://doi.org/10.1016/j.transproceed.2026.02.019