lutetium-177 oxodotreotide + temozolomide + radiotherapy

This is a **combination therapy** comprising three components: - **Lutetium-177 oxodotreotide** (also known as [177Lu]Lu-DOTA-TATE, marketed as Lutathera), a radiopharmaceutical used for targeted radionuclide therapy. It consists of lutetium-177, a beta-emitting radioisotope, conjugated to the somatostatin analog oxodotreotide via a DOTA chelator. This compound selectively binds to somatostatin receptor type 2 (SSTR2) overexpressed on certain tumor cells, delivering targeted beta radiation to the tumor and causing DNA damage and cell death. - **Temozolomide**, an oral alkylating agent (small-molecule chemotherapy) that induces cytotoxicity mainly by methylating DNA at the O6 and N7 positions of guanine, which interferes with DNA replication and leads to tumor cell death. It is primarily used in the treatment of gliomas. - **Radiotherapy** (specifically external beam radiotherapy – EBRT), which employs ionizing radiation to induce irreparable DNA damage and cell death in targeted tumor tissues. The combination has been studied in newly diagnosed glioblastoma to assess synergy and enhanced tumoricidal activity, with lutetium-177 oxodotreotide providing targeted internal radiation, temozolomide acting as a radiosensitizer as well as direct cytotoxin, and EBRT delivering additional localized external radiation[1][4][7].