Alpha-Radiation Imaging Agent ([203Pb]VMT-alpha-NET) with SPECT/CT Imaging to Identify Somatostatin Receptor Positive Neuroendocrine Tumors

Inclusion Criteria

• Ability to understand and willingness to provide informed consent
• Stated willingness to comply with all study procedures and availability for duration of study
• Aged >= 18 years at the time of study drug administration
• Pathologically confirmed (histology or cytology) well-differentiated neuroendocrine tumor (World Health Organization [WHO] grade 1 or 2) with primary location known or believed to be midgut or foregut
• At least 1 somatostatin receptor positive tumor site as demonstrated by PET/CT study utilizing and Food and Drug Administration (FDA) approved PET agent within 12 months of consent
• >= 1 evaluable site of disease measuring >= 2.0 cm in any dimension on CT or magnetic resonance imaging (MRI)
• Adequate performance status (Eastern Cooperative Oncology Goup [ECOG] of 0 or 1; or Karnofsky Performance Status [KPS] of >= 70)
• Not experiencing an uncontrolled intercurrent illness such as: infection requiring inpatient admission, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, psychiatric illness/social situations, or any other condition that would limit compliance with study requirements as determined by study team members

Exclusion Criteria

• Women who are pregnant or breast feeding. A pregnancy test will be administered to women of childbearing potential (per institutional policies) at screening. Women must agree to pregnancy tests prior to each administration of a radionuclidic agent for this study
• Females or males of reproductive potential who decline to use effective contraception through the study (22 days equaling 10 half-lives)
• Lactating women who decline to withhold breastfeeding their child. As the effects of [203Pb]VMT-alpha-NET on the infant are unknown and relatively long half-life, women may not resume breast feeding for the current child
• Therapeutic investigational drug within 4 weeks of cycle (C)1 day (D)1
• Patients for whom, in the opinion of their physician, a 24-hour discontinuation of somatostatin analogue therapy represents a health risk
• Subject’s weight exceeds the limit of the imaging system
• Long-acting somatostatin analogue treatment =< 20 days of C1D1
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to [90Y]DOTA-tyr3-octreotide, Octreoscan (registered trademark), or [68Ga]octreotide