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ASCO 2026 | Mechanism of 177Lu-dotatate in SSTR2-positive meningioma

Sylvia Kurz, MD, PhD, Yale University School of Medicine, New Haven, CT, discusses the mechanism of action of 177-lutetium dotatate in meningiomas, highlighting that it binds to SSTR2 on the cell surface and is internalized, allowing the radioactivity to radiate the cell from within without influencing cellular pathways. This mechanism is distinct from other SSTR2-targeted agents, such as somatostatin analogs. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

So SSTR2 is expressed very highly and uniformly in meningiomas, so it’s 95% of meningiomas that will have SSTR2 expression. Compared to other agents like somatostatin analogs, which also target SSTR2, the 177-lutetium dotatate doesn’t necessarily influence the pathways or the biological mechanisms within the cell, but it really kind of serves as like a carrier...

So SSTR2 is expressed very highly and uniformly in meningiomas, so it’s 95% of meningiomas that will have SSTR2 expression. Compared to other agents like somatostatin analogs, which also target SSTR2, the 177-lutetium dotatate doesn’t necessarily influence the pathways or the biological mechanisms within the cell, but it really kind of serves as like a carrier. Like the SSTR2 on the meningioma cell kind of binds to the lutetium dotatate, and then the construct gets internalized into the cell. It doesn’t necessarily influence the pathways within the cell, but the radioactivity that’s getting absorbed by the cell radiates the cell from within. And that’s like a fundamentally different mechanism of action compared to other SSTR2-targeted agents.

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