A single cycle of Actinium-225 PRRT with DOTA-LM3 achieved complete remission of metastatic neuroendocrine cancer — confirmed at autopsy, a first in the literature.
First autopsy-confirmed complete remissionOne cycle of alpha-PRRT eliminated all viable cancer cells across multiple metastatic sites — confirmed pathologically at autopsy
What the researchers found
Autopsy confirmed complete pathological remission of widely metastatic neuroendocrine cancer after just one cycle of [225Ac]Ac-DOTA-LM3 alpha-PRRT — a first in the literature.
Why it matters
Autopsy-confirmed complete remission is the gold standard for proving a treatment works. This first-ever case demonstrates the extraordinary cancer-killing potential of alpha-particle PRRT.
The numbers in context
78-year-old man. NEN G2 from tailgut cyst. Prior surgery, lanreotide, and Lu-177 DOTATATE. 1 cycle Ac-225 DOTA-LM3. Complete remission confirmed at autopsy. Death from gastric adenocarcinoma (unrelated).
How the study worked
Single case report with autopsy confirmation of treatment response after one cycle of Actinium-225 labeled DOTA-LM3 PRRT.
Who was studied
One man with recurrent NEN G2 from tailgut cyst
What this study cannot tell us
Single case — cannot determine how often complete remission occurs. The patient died from an unrelated complication (bile duct obstruction), so long-term survival benefit could not be assessed.
How to read the evidence
Single case report, but with the strongest possible endpoint — autopsy-confirmed complete pathological remission. This is unprecedented evidence for alpha-PRRT efficacy.
When this study was published
Published in 2025, establishing a landmark case in targeted alpha-particle therapy for cancer.
The bigger picture
This case fundamentally validates alpha-particle PRRT as a potentially curative approach for neuroendocrine cancers, even in heavily metastatic disease.
Questions still open
- How often does single-cycle alpha-PRRT achieve complete pathological remission?
- Could earlier use of alpha-PRRT prevent the need for multiple treatment cycles?
Common questions
What makes this case so significant?
What is alpha-particle radiation therapy?
Read the original research
First Autopsy-confirmed Complete Remission of Metastatic Neuroendocrine Neoplasm of Tailgut Cyst After a Single Cycle of Alpha-Peptide Receptor Radionuclide Therapy With [225Ac]Ac-DOTA-LM3.
Clinical nuclear medicine
Citation
Perrone, Elisabetta; Shaheen, Shagufta; Kunz, Pamela L; Henri, Heather C; Baum, Richard P. (2025). First Autopsy-confirmed Complete Remission of Metastatic Neuroendocrine Neoplasm of Tailgut Cyst After a Single Cycle of Alpha-Peptide Receptor Radionuclide Therapy With [225Ac]Ac-DOTA-LM3.. Clinical nuclear medicine. https://doi.org/10.1097/RLU.0000000000006201