Nens: From diagnosis to therapy – a theragnostic approach: Part II

Diagnostics and therapy in neuroendocrine tumors (NETs) has been heavily influenced by nuclear medicine progresses, both from a diagnostic and therapeutic perspective. The introduction of somatostatin-based peptides, labeled to radionuclides (constituting radiopharmaceuticals), such as the current golden standard 68Ga-DOTA-SSAs (SomatoStatin Analogues), has revolutionized the approach to these neoplasms. That is not all: these radiopharmaceuticals have been employed also into a therapeutic context, realizing the so-called PRRT (peptide receptor radionuclide therapy), allowing NENs to be integrated into a comprehensive theragnostic approach, making advantage of the knowledge based on receptor overexpression of neuroendocrine tumors, in particular SSTRs (somatostatin receptors). PRRT is mainly focused on the utilization of 90Y-and 177Lu-based peptides, but in this case another important factor is needed: the internalization process, a pivotal phenomenon that allows the efficacy of the therapy, thanks to the intracellular collection of radioisotopes: in this way, they are able to damage internal structures of neoplastic cells.