TANDEM Radiation Therapy Achieves Partial Remission in Rare Parotid Gland Cancer Metastasis
A patient with pancreatic neuroendocrine cancer metastasized to the parotid gland achieved partial remission with TANDEM PRRT using Actinium-225 and Lutetium-177 with somatostatin receptor antagonist DOTA-LM3.
Quick Facts
What This Study Found
TANDEM PRRT with Ac-225/Lu-177 labeled DOTA-LM3 (somatostatin receptor antagonist) achieved partial remission in all metastatic sites of a treatment-refractory pancreatic NEN with parotid metastasis.
Key Numbers
38-year-old woman. Pancreatic NEN with parotid metastasis. Prior DOTATOC PRRT and surgery failed. 2 cycles TANDEM-PRRT (Ac-225 + Lu-177 DOTA-LM3). Partial remission in parotid and liver.
How They Did This
Single case report of a 38-year-old woman with progressive metastatic pancreatic NEN treated with TANDEM PRRT after failure of prior therapies.
Why This Research Matters
This demonstrates that when standard PRRT fails, switching to a receptor antagonist-based approach with alpha-emitting radiation can still achieve meaningful tumor control.
The Bigger Picture
TANDEM therapy combining alpha and beta radiation with receptor antagonists represents a new frontier in targeted radionuclide therapy for treatment-resistant neuroendocrine cancers.
What This Study Doesn't Tell Us
Single case report — success in one patient does not guarantee broader efficacy. Optimal dosing and long-term outcomes need larger studies.
Questions This Raises
- ?Is TANDEM therapy with DOTA-LM3 more effective than sequential alpha-then-beta approaches?
- ?What is the long-term durability of TANDEM PRRT responses?
Trust & Context
- Key Stat:
- Partial remission after 2 cycles All metastatic sites responded to TANDEM PRRT after failure of prior conventional treatments
- Evidence Grade:
- Single case report — lowest evidence level but demonstrates feasibility and efficacy of a novel therapeutic approach in a treatment-resistant setting.
- Study Age:
- Published in 2025, representing the cutting edge of targeted alpha-beta radionuclide combination therapy.
- Original Title:
- TANDEM Peptide Receptor Radionuclide Therapy Using [ 225 Ac]Ac-/[ 177 Lu]Lu-DOTA-LM3 in a Patient With Parotid Gland Metastasis From Pancreatic Neuroendocrine Neoplasm.
- Published In:
- Clinical nuclear medicine, 50(10), e605-e607 (2025)
- Authors:
- Perrone, Elisabetta(4), Ghai, Kriti(3), Eismant, Aleksandr(3), Baum, Richard P
- Database ID:
- RPEP-13028
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
What is TANDEM PRRT?
TANDEM therapy combines two types of targeted radiation in one treatment — alpha particles (from Actinium-225) that destroy cells at very close range, and beta particles (from Lutetium-177) that cover a wider area. Both are attached to peptides that home to cancer cells.
What makes DOTA-LM3 different from standard PRRT?
DOTA-LM3 is a somatostatin receptor antagonist, while standard PRRT agents (like DOTATATE) are agonists. Antagonists bind to more receptor sites on the tumor surface, potentially delivering more radiation to cancer cells.
Read More on RethinkPeptides
Cite This Study
https://rethinkpeptides.com/research/RPEP-13028APA
Perrone, Elisabetta; Ghai, Kriti; Eismant, Aleksandr; Baum, Richard P. (2025). TANDEM Peptide Receptor Radionuclide Therapy Using [ 225 Ac]Ac-/[ 177 Lu]Lu-DOTA-LM3 in a Patient With Parotid Gland Metastasis From Pancreatic Neuroendocrine Neoplasm.. Clinical nuclear medicine, 50(10), e605-e607. https://doi.org/10.1097/RLU.0000000000005782
MLA
Perrone, Elisabetta, et al. "TANDEM Peptide Receptor Radionuclide Therapy Using [ 225 Ac]Ac-/[ 177 Lu]Lu-DOTA-LM3 in a Patient With Parotid Gland Metastasis From Pancreatic Neuroendocrine Neoplasm.." Clinical nuclear medicine, 2025. https://doi.org/10.1097/RLU.0000000000005782
RethinkPeptides
RethinkPeptides Research Database. "TANDEM Peptide Receptor Radionuclide Therapy Using [ 225 Ac]..." RPEP-13028. Retrieved from https://rethinkpeptides.com/research/perrone-2025-tandem-peptide-receptor-radionuclide
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.