NETTER-1: 177Lu-Dotatate for midgut neuroendocrine tumours progressing on octreotide
Radioligand therapy with lutetium-177 dotatate reduced the risk of progression or death by nearly 80 percent compared with high-dose octreotide in midgut neuroendocrine tumours, the first randomised proof that targeted radiation works in these cancers.
Overview
Phase 3 trial of 229 patients with advanced, progressive, somatostatin receptor-positive midgut neuroendocrine tumours randomised to four cycles of 177Lu-Dotatate plus octreotide LAR 30 mg or high-dose octreotide LAR 60 mg.
Progression-free survival at 20 months was 65.2 versus 10.8 percent (hazard ratio 0.21), response 18 versus 3 percent, and an interim analysis suggested improved overall survival; myelosuppression was modest.
- Progression-free survival hazard ratio 0.21; 20-month rate 65.2 percent vs 10.8 percent.
- Objective response 18 percent vs 3 percent.
Lutetium-177 dotatate is a standard treatment for progressive small bowel neuroendocrine tumours after somatostatin analogues, and NETTER-2 has since moved it into first-line use for higher-grade tumours.
- Final overall survival difference (48.0 vs 36.3 months) did not reach significance, partly because of crossover.
- Rare late myelodysplasia and leukaemia.
Similar pages
not linked directly; found by shared links- Key paperCLARINET: lanreotide in metastatic enteropancreatic neuroendocrine tumours
Shares Small intestinal neuroendocrine tumours, New England Journal of Medicine.
- Key paperCABINET (Alliance A021602): cabozantinib for advanced neuroendocrine tumours
Shares Small intestinal neuroendocrine tumours, New England Journal of Medicine.
- TreatmentSomatostatin analogues (octreotide, lanreotide)
- TechnologyPeptide receptor radionuclide therapy (PRRT)