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Terbium-161 dotatate is an investigational radiopharmaceutical being developed for the treatment of neuroendocrine tumors (NETs), specifically gastroenteropancreatic neuroendocrine tumors (GEP-NETs). It consists of the radioisotope terbium-161 conjugated to the somatostatin analog peptide DOTATATE. As a peptide receptor radionuclide therapy (PRRT), it targets the somatostatin receptor subtype 2 (SSTR2), which is frequently overexpressed on the surface of neuroendocrine tumor cells. Terbium-161 is unique because it emits not only beta particles but also a high density of Auger and conversion electrons. These Auger electrons have a shorter range and higher linear energy transfer, potentially offering superior therapeutic efficacy for small clusters of tumor cells or micrometastases compared to the standard lutetium-177-based therapies. Tata Memorial Hospital is currently evaluating its safety and efficacy in a Phase 2 trial for patients who have progressed after standard [177Lu]Lu-DOTATATE therapy.
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