Alpha Radiation Therapy for Resistant Neuroendocrine Cancers: Safety and Survival in 35 Patients
Actinium-225 PRRT with DOTA-LM3 showed manageable safety and promising survival in 35 patients with advanced neuroendocrine cancers resistant to conventional treatment.
Quick Facts
What This Study Found
35 patients received 57 cycles of [225Ac]Ac-DOTA-LM3 (alone or TANDEM with Lu-177) for resistant NEN, showing manageable safety and promising survival outcomes.
Key Numbers
35 patients, 57 cycles (24 monotherapy, 33 TANDEM). March 2022-September 2024. Pancreas most common primary (n=19). Mostly mild acute adverse events (nausea n=8). Grade 3/4: anemia (n=2), leukocytopenia (n=1).
How They Did This
Retrospective study of 35 patients with advanced SSTR-positive NEN treated with Ac-225 DOTA-LM3 PRRT (monotherapy and TANDEM), assessing safety, survival, and follow-up duration.
Why This Research Matters
This is the largest published series on Ac-225 alpha-PRRT for neuroendocrine cancers, providing critical safety and efficacy data for a treatment approach that may become standard care.
The Bigger Picture
This study builds the evidence base needed for alpha-PRRT to move from experimental to standard treatment for resistant neuroendocrine cancers.
What This Study Doesn't Tell Us
Retrospective design without a control group. Patient heterogeneity in prior treatments and disease characteristics. Small sample for definitive survival analysis.
Questions This Raises
- ?What is the optimal dosing and number of cycles for Ac-225 PRRT?
- ?How does TANDEM therapy compare to Ac-225 monotherapy in outcomes?
Trust & Context
- Key Stat:
- 35 patients, 57 cycles Largest published experience with Actinium-225 alpha-PRRT using somatostatin receptor antagonist for resistant neuroendocrine cancers
- Evidence Grade:
- Retrospective case series — the largest for this therapy. While not a controlled trial, it provides the most comprehensive safety and survival data available.
- Study Age:
- Published in 2025, covering treatment experience from 2018-2023 — the most comprehensive safety dataset for this therapy.
- Original Title:
- Peptide Receptor Radionuclide Therapy (PRRT) Using Actinium-225- and Ac-225/Lutetium-177-Labeled (TANDEM) Somatostatin Receptor Antagonist DOTA-LM3 in Patients with Neuroendocrine Neoplasm: A Retrospective Study Concerning Safety and Survival.
- Published In:
- Cancers, 17(18) (2025)
- Authors:
- Perrone, Elisabetta(4), Calcagni, Maria Lucia, Leccisotti, Lucia, Moretti, Roberto, Ghai, Kriti, Eismant, Aleksandr, Parkar, Tanay, Greifenstein, Lukas, Baum, Richard Paul
- Database ID:
- RPEP-13027
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
What happens when standard radiation therapy for neuroendocrine cancer stops working?
Alpha-particle PRRT with Actinium-225 offers a more powerful radiation option. This study shows it can be given safely to patients who have progressed on standard Lutetium-177 therapy.
What are the main side effects of alpha-PRRT?
The study reports manageable toxicity including hypoglycemia flare (in insulinoma patients) and blood count changes. Overall, the therapy was tolerable in this 35-patient experience.
Read More on RethinkPeptides
Cite This Study
https://rethinkpeptides.com/research/RPEP-13027APA
Perrone, Elisabetta; Calcagni, Maria Lucia; Leccisotti, Lucia; Moretti, Roberto; Ghai, Kriti; Eismant, Aleksandr; Parkar, Tanay; Greifenstein, Lukas; Baum, Richard Paul. (2025). Peptide Receptor Radionuclide Therapy (PRRT) Using Actinium-225- and Ac-225/Lutetium-177-Labeled (TANDEM) Somatostatin Receptor Antagonist DOTA-LM3 in Patients with Neuroendocrine Neoplasm: A Retrospective Study Concerning Safety and Survival.. Cancers, 17(18). https://doi.org/10.3390/cancers17183070
MLA
Perrone, Elisabetta, et al. "Peptide Receptor Radionuclide Therapy (PRRT) Using Actinium-225- and Ac-225/Lutetium-177-Labeled (TANDEM) Somatostatin Receptor Antagonist DOTA-LM3 in Patients with Neuroendocrine Neoplasm: A Retrospective Study Concerning Safety and Survival.." Cancers, 2025. https://doi.org/10.3390/cancers17183070
RethinkPeptides
RethinkPeptides Research Database. "Peptide Receptor Radionuclide Therapy (PRRT) Using Actinium-..." RPEP-13027. Retrieved from https://rethinkpeptides.com/research/perrone-2025-peptide-receptor-radionuclide-therapy
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkPeptides research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.