Radioactive Peptide Therapy for Neuroendocrine Cancer That Has Spread to the Abdomen | Research

The takeaway

PRRT with Lu-177 DOTATATE showed limited tumor shrinkage in peritoneal neuroendocrine disease but carried risk of intestinal complications.

20 patients
Sequential PET/CT monitoring showed peritoneal disease volumes remained stable despite PRRT

What the researchers found

PRRT showed limited response in peritoneal/mesenteric neuroendocrine disease (stable volumes) despite responses in liver metastases, with digestive complication risks.

Why it matters

Peritoneal neuroendocrine disease is particularly difficult to treat — understanding PRRT's limitations here guides treatment expectations.

The numbers in context

N=20; 17 with peritoneal carcinomatosis; functional response rate: PC/MF 18.7% vs liver 38%; 8% of all PRRT patients needed unplanned ED care.

How the study worked

Prospective study of 20 patients with sequential [68Ga]DOTATOC PET/CT before, during, and after [177Lu]DOTATATE PRRT.

Who was studied

Patients with small-intestine neuroendocrine tumors and peritoneal disease receiving PRRT

What this study cannot tell us

Small sample (20 patients). No control group. Variable disease burden and prior treatments.

How to read the evidence

Small prospective cohort with imaging endpoints — informative but limited by sample size and absence of control group.

When this study was published

Published in 2025, addressing a specific gap in PRRT efficacy data for peritoneal disease.

The bigger picture

This identifies peritoneal disease as a relative resistance point for PRRT, suggesting combination approaches or alternative strategies may be needed.

Questions still open

Would higher PRRT doses improve peritoneal response?
Should peritoneal neuroendocrine disease be treated with combined PRRT and surgery?

Common questions

What is PRRT?

Peptide receptor radionuclide therapy — a targeted radiation treatment that delivers radioactive molecules to neuroendocrine tumor cells via their surface receptors.

Does PRRT work for cancer that has spread to the abdomen?

This study found limited response in peritoneal disease compared to liver metastases, suggesting peritoneal spread is harder to treat with PRRT alone.

Read the original research

Neuroendocrine peritoneal disease and [177Lu]DOTATATE peptide receptor radionuclide therapy: a therapeutic challenge with potential clinical complications.

European journal of nuclear medicine and molecular imaging, 52(10), 3682-3689

View on PubMed ↗Publisher’s paper ↗

Citation

Poterszman, Nathan; Baltzinger, Philippe; Mamulashvili Bessac, Darejan; Pham Van, Floriane; Goichot, Bernard; Mertz, Luc; Addeo, Pietro; Brigand, Cecile; Imperiale, Alessio. (2025). Neuroendocrine peritoneal disease and [177Lu]DOTATATE peptide receptor radionuclide therapy: a therapeutic challenge with potential clinical complications.. European journal of nuclear medicine and molecular imaging, 52(10), 3682-3689. https://doi.org/10.1007/s00259-025-07212-3