Italian Association of Nuclear Medicine, Molecular Imaging and Therapy (AIMN) practical guide for peptide receptor radionuclide therapy (PRRT) with [177Lu]Lu-Oxodotreotide in gastroenteropancreatic neuroendocrine tumors (GEP-NET)

Somatostatin receptors (SSTR) are overexpressed by most neuroendocrine tumors (NETs), and patients with SSTR-positive disease can be identified by DOTA-peptide PET. Phase II and III studies proved SSTR-targeted radiopharmaceutical therapy safe and effective in metastatic gastroenteropancreatic (GEP) NETs progressed after SST analogues. Additional data indicate that [177Lu]Lu-oxodotreotide peptide receptor radionuclide therapy (PRRT) also has high potential in earlier clinical situations. The purpose of this Italian procedural guideline is to assist the nuclear medicine personnel in the delivery of [177Lu]Lu-DOTA-peptide therapy, from patient selection to end-of-therapy follow-up, and to facilitate the management of possible side effects and their clinical management. The current document is based upon the current best practice and knowledge of experienced Centers and Nuclear Medicine Physicians in Italy.