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lutetium (177lu) dotatate

Peptide receptor radioligand therapy · Radiopharmaceutical, Antineoplastic agent

Peptide receptor radioligand therapyRadiopharmaceutical, Antineoplastic agentATC V10XX04
CDSCO approvedATC V10XX04
EXCRETION
not curated
INTERACTIONS
none in our sources
PREGNANCY
not curated

Mechanism

Lutetium (177Lu)-DOTA-octreotate (177Lu-dotatate) is a radioligand coupled to a somatostatin analogue. The somatostatin analogue targets and binds to somatostatin receptors expressed on tumor cells. Upon internalization, the radioligand emits both β particles (causing localized cell death) and lower-energy γ particles (allowing imaging), leading to tumor cell cytotoxicity.

Indications

Inoperable, somatostatin receptor-positive midgut neuroendocrine tumors (NETs)Advanced gastroenteropancreatic neuroendocrine tumors (NETs) of higher grade (grade 2 or 3)

Dosing

Adult
Four doses administered intravenously every 8 weeks (in NETTER-1 trial).

Side effects

Serious
  • Renal toxicity (mitigated with coadministration of intravenous amino acids)
  • Acute leukemia (rare)
  • Myelodysplastic syndrome (rare)

Related guidelines

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Sources: Harrison 22e·Verified: 2026-05-10 · House clinical team