Clinical Significance of Radioligand Therapy with <sup>177</sup>Lu-DOTATATE and the Role of Pharmacists

Radioligand therapy (RLT) has emerged as a novel therapeutic approach for various cancers. Among RLT agents, 177Lu-DOTATATE specifically targets somatostatin receptors, which are highly expressed on neuroendocrine tumor (NET) cells, and exerts antitumor effects through β-emission. The efficacy of 177Lu-DOTATATE was demonstrated in a phase III clinical trial, which led to regulatory approvals in various countries and transformed the treatment landscape for NETs. Consequently, the clinical relevance of RLT as a new therapeutic modality is increasingly recognized. Pharmacists play a critical role in the safe and effective implementation of this therapy. Their responsibilities include radiopharmaceutical preparation, regimen-based administration management, drug-related information provision, and adverse effects monitoring. Nuclear medicine-certified pharmacists collaborate with multidisciplinary teams to ensure the safety and efficacy of treatment. This review outlines the pharmacological characteristics and clinical development of 177Lu-DOTATATE, as well as its current challenges and future perspectives, with a focus on the involvement of pharmacists in clinical practice.