{"entity":{"id":"neuroendocrine","kind":"indication","name":"Neuroendocrine tumours","aka":["Gastrointestinal Neuroendocrine Tumors","Pancreatic Neuroendocrine Tumors (Islet Cell Tumors)"],"tldr":"A family of usually slow-growing tumours that start in hormone-producing cells of the gut, pancreas and lungs. They pioneered the idea of using the same molecule to see a tumour on a scan and then to treat it with radiation.","summary":"Neuroendocrine neoplasms range from indolent grade 1 tumours that patients live with for decades to poorly differentiated neuroendocrine carcinomas that behave like small-cell lung cancer. Most arise in the small bowel, pancreas, rectum or lung; many secrete hormones (serotonin, insulin, gastrin) that cause syndromes, and most well-differentiated tumours express somatostatin receptor 2 (SSTR2), which is the hinge of both diagnosis and therapy. Incidence has risen six-fold over 40 years, largely from incidental detection on imaging and endoscopy.\n\nTherapy is sequenced by grade, receptor status and tempo. Somatostatin analogues (octreotide, lanreotide) control symptoms and slow growth (PROMID, CLARINET). For progression, peptide receptor radionuclide therapy with 177Lu-DOTATATE (NETTER-1; NETTER-2 first line for grade 2-3) is standard, and 177Lu-edotreotide beat everolimus head-to-head in COMPETE (PFS 23.9 vs 14.1 months) with an FDA decision due August 2026. Targeted pills (everolimus, sunitinib, and since March 2025 cabozantinib after CABINET) and chemotherapy (CAPTEM for pancreatic NETs; platinum-etoposide for neuroendocrine carcinoma) fill in. Surgery and liver-directed therapy (resection, embolisation, ablation, transplant in rare cases) remain central because disease is often liver-dominant.\n\nThe frontier is alpha-emitting PRRT: 212Pb-DOTAMTATE (AlphaMedix) met all primary endpoints in phase 2 with a 54% response rate in PRRT-naive patients and Breakthrough designation, and 225Ac-DOTATATE (RYZ101) is in the phase 3 ACTION-1 trial after lutetium failure. SSTR antagonist ligands, dosimetry-personalised dosing, and combinations with CAPTEM or immunotherapy are being tested. Open problems include the lack of randomised evidence for sequencing, the absence of effective therapy for SSTR-negative and high-grade disease, a 2-3% risk of therapy-related leukaemia after PRRT, and isotope supply.","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Neuroendocrine_tumor","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Neuroendocrine_tumor"}],"tags":["endocrine","spike"],"related":["sstr-pet-to-prrt","prrt-then-alpha-net","radiopharma-roadmap","beta-then-alpha","lu-177","ac-225","pb-212"],"indications":[],"sections":[],"technologies":["radioligand-therapy","targeted-alpha-therapy","pet","sstr-pet","prrt","pet-ct","radioembolisation-tare"],"targets":["sstr2","dll3"],"drugs":["iobenguane-i-131"],"companies":["sinotau-pharmaceutical","novartis","itm","orano-med","radiomedix","rayzebio","bms","pfizer"],"institutions":["mskcc","heidelberg-nct","royal-marsden"],"pathways":[],"terms":["net-grade-ki67","theranostics","alpha-vs-beta","dosimetry"],"trials":["netter-1","nct05459844","nct06398444","nct04919226"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"endocrine","burden":"About 7 per 100,000 people per year in the US, rising six-fold since the 1970s; prevalence is high because many patients live for years (>170,000 living with NETs in the US).","subtypes":["Small-bowel (midgut) NET, often with carcinoid syndrome","Pancreatic NET (functioning: insulinoma, gastrinoma, glucagonoma; non-functioning)","Lung NET (typical and atypical carcinoid)","Rectal and appendiceal NET (often incidental, excellent prognosis)","Grade 3 well-differentiated NET","Neuroendocrine carcinoma (small- and large-cell), treated like SCLC","Hereditary: MEN1, VHL, NF1, TSC; paraganglioma/phaeochromocytoma (SDHx)"],"biomarkers":["Ki-67 grade","SSTR PET uptake","Chromogranin A","MEN1, DAXX/ATRX","Ki-67 index and mitotic count (WHO grade)","SSTR2 expression by 68Ga/64Cu-DOTATATE PET","FDG PET avidity (high-grade or dedifferentiated disease)","Chromogranin A (monitoring)","24-hour urinary 5-HIAA (carcinoid syndrome)","Germline MEN1, VHL, SDHx testing","MGMT status (CAPTEM response, investigational)"],"standardOfCare":[{"setting":"Localised","approach":"Resection.","refs":[],"guideline":{"version":"NCCN Guidelines: Neuroendocrine and Adrenal Tumors","url":"https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1448"}},{"setting":"Advanced","approach":"SSA → 177Lu-DOTATATE → everolimus/cabozantinib/chemotherapy; alpha therapy in trials.","refs":["lutathera","ryz101"],"guideline":{"version":"NCCN Guidelines: Neuroendocrine and Adrenal Tumors","url":"https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1448"}},{"setting":"Diagnosis and staging","approach":"Histology with Ki-67 grading; 68Ga/64Cu-DOTATATE PET/CT ± FDG PET; triple-phase CT or MRI of the liver; chromogranin A and syndrome-specific hormones; germline testing for pancreatic NETs and paragangliomas.","refs":["sstr-pet","net-grade-ki67"],"guideline":{"nccn":"Neuroendocrine and Adrenal Tumors","version":"NCCN 2026 / ENETS 2023"}},{"setting":"Localised disease","approach":"Surgical resection (including primary tumour resection with liver metastases where feasible); endoscopic resection for small rectal/gastric NETs; surveillance for small incidental lesions.","refs":[],"guideline":{"nccn":"Category 2A"}},{"setting":"Advanced, grade 1-2, SSTR-positive, first line","approach":"Somatostatin analogue (octreotide LAR or lanreotide); 177Lu-DOTATATE first line for grade 2-3 (NETTER-2) with high burden.","refs":["lutathera","prrt"],"guideline":{"nccn":"Category 1 (SSA); category 1 PRRT for grade 2-3 first line"}},{"setting":"Advanced, progression on SSA","approach":"PRRT with 177Lu-DOTATATE (or 177Lu-edotreotide if approved); everolimus; sunitinib (pancreatic); cabozantinib (CABINET, all sites).","refs":["lutathera","itm-11","compete","everolimus","radiant-3-4","sunitinib","cabozantinib","cabinet"],"guideline":{"nccn":"Category 1 for PRRT and cabozantinib; 2A sequencing"}},{"setting":"Advanced pancreatic NET needing tumour shrinkage","approach":"CAPTEM (E2211); PRRT; liver-directed therapy for hepatic-dominant disease.","refs":["radioembolisation-tare"],"guideline":{"nccn":"Category 2A"}},{"setting":"Carcinoid syndrome","approach":"SSA dose escalation; telotristat ethyl for refractory diarrhoea; octreotide infusion peri-procedurally; echocardiographic screening for carcinoid heart disease.","refs":[],"guideline":{"nccn":"Category 2A"}},{"setting":"Neuroendocrine carcinoma (poorly differentiated)","approach":"Platinum-etoposide (as in SCLC) ± PD-L1 inhibitor by extrapolation; FOLFIRINOX or CAPTEM in later lines; DLL3-directed agents in trials.","refs":[],"guideline":{"nccn":"Category 2A"}},{"setting":"After PRRT failure","approach":"Everolimus or cabozantinib; alpha PRRT in trials (ACTION-1, AlphaMedix); PRRT retreatment in selected patients.","refs":["ryz101","action-1","alphamedix","prrt-then-alpha-net"],"guideline":{"nccn":"Trials preferred"}},{"setting":"VHL-associated pancreatic NET","approach":"Belzutifan (approved 2021) for non-metastatic tumours not requiring immediate surgery.","refs":[],"guideline":{"nccn":"Category 2A"}}],"stateOfArt":["Theranostic paradigm; first-line PRRT in higher-grade disease.","Theranostic paradigm is routine: SSTR PET selects, 177Lu-DOTATATE treats, including first line for grade 2-3 disease.","First head-to-head radioligand-versus-drug trial (COMPETE) won on PFS; FDA decision on 177Lu-edotreotide due 28 August 2026.","Cabozantinib approved (2025) across pancreatic and extra-pancreatic NETs after prior therapy, with an 81% reduction in progression risk in lung/thymic NETs.","Alpha PRRT (212Pb-DOTAMTATE) met all phase 2 endpoints with Breakthrough designation; 225Ac-DOTATATE in phase 3.","Germline testing and syndrome-directed care (belzutifan for VHL) are standard for pancreatic NETs."],"history":[{"year":1907,"title":"Oberndorfer coins 'Karzinoid' for small-bowel tumours","refs":[]},{"year":1954,"title":"Carcinoid syndrome described (Thorson)","refs":[]},{"year":1987,"title":"Octreotide approved","refs":[]},{"year":1988,"title":"Octreotide approved for carcinoid syndrome","refs":[]},{"year":1994,"title":"111In-octreotide scintigraphy (OctreoScan) approved","note":"First SSTR imaging; later replaced by PET.","refs":["sstr-pet"]},{"year":2000,"title":"First 90Y- and 177Lu-DOTATOC/DOTATATE PRRT series (Rotterdam, Basel)","refs":["prrt"]},{"year":2009,"title":"PROMID: octreotide slows tumour growth","refs":[]},{"year":2011,"title":"Everolimus (RADIANT-3) and sunitinib approved for pancreatic NETs","refs":["radiant-3-4","everolimus","sunitinib"]},{"year":2014,"title":"CLARINET: lanreotide antiproliferative approval","refs":[]},{"year":2016,"title":"68Ga-DOTATATE PET (Netspot) approved; RADIANT-4 extends everolimus to lung/GI NETs","refs":["sstr-pet","radiant-3-4"]},{"year":2018,"title":"Lutathera approved","refs":["lutathera"]},{"year":2018,"title":"Lutathera approved (NETTER-1): PRRT enters standard care","refs":["lutathera","prrt"]},{"year":2020,"title":"SANET trials positive in China (surufatinib)","refs":[]},{"year":2024,"title":"NETTER-2: first-line PRRT","refs":[]},{"year":2024,"title":"NETTER-2: PRRT first line in grade 2-3; CABINET published; AlphaMedix Breakthrough designation","refs":["lutathera","cabinet","alphamedix"]},{"year":2025,"title":"Cabozantinib approved (March); COMPETE positive (ENETS, Lancet); AlphaMedix phase 2 meets all endpoints (October)","refs":["cabozantinib","compete","alphamedix-02"]},{"year":2026,"title":"FDA accepts 177Lu-edotreotide NDA (PDUFA 28 August); ACTION-1 dosimetry published; pancreatic subgroup of COMPETE at ENETS","refs":["itm-11","action-1"]}],"pipeline":["ryz101","itm-11","compete","alphamedix","alphamedix-02","action-1","prrt","sstr-pet","cabozantinib","idea-net-dosimetry-prrt","idea-net-antagonist-ligands","prrt-then-alpha-net","dll3"],"openProblems":["Neuroendocrine carcinoma (high grade) behaves like SCLC.","Sequencing of PRRT vs targeted therapy.","Sequencing is unproven: no randomised trial orders SSA, PRRT, everolimus, cabozantinib and chemotherapy.","SSTR-negative, FDG-avid and high-grade disease has few options; neuroendocrine carcinoma outcomes remain poor.","Therapy-related MDS/AML (~2-3%) and renal toxicity after PRRT; long-term data on retreatment are thin.","Overall survival benefits are hard to demonstrate because patients live for years and cross over.","Isotope supply (177Lu, 212Pb, 225Ac) and nuclear-medicine capacity limit access outside major centres.","Chromogranin A is an unreliable marker; better blood tests (NETest, ctDNA) are not validated for decisions.","Rare syndromic and paediatric NETs lack trials; hereditary carriers need lifelong surveillance protocols."]},"route":"/indications/neuroendocrine/","neighbours":{"pairing":[{"id":"ga68-dotatate-then-lutathera","kind":"pairing","name":"68Ga-DOTATATE PET before Lutathera (177Lu-DOTATATE)","route":"/pairings/ga68-dotatate-then-lutathera/"},{"id":"prrt-then-alpha-net","kind":"pairing","name":"Beta PRRT → alpha PRRT","route":"/pairings/prrt-then-alpha-net/"},{"id":"beta-then-alpha","kind":"pairing","name":"Beta radioligand → alpha radioligand","route":"/pairings/beta-then-alpha/"},{"id":"prrt-plus-captem","kind":"pairing","name":"PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)","route":"/pairings/prrt-plus-captem/"},{"id":"sstr-pet-to-prrt","kind":"pairing","name":"SSTR PET → PRRT","route":"/pairings/sstr-pet-to-prrt/"}],"roadmap":[{"id":"radiopharma-roadmap","kind":"roadmap","name":"Radiopharmaceutical roadmap: iodine → lutetium → actinium","route":"/roadmaps/radiopharma-roadmap/"},{"id":"sstr-theranostics-roadmap","kind":"roadmap","name":"SSTR theranostics roadmap: octreotide scintigraphy → 68Ga-DOTATATE → 177Lu-DOTATATE → alpha","route":"/roadmaps/sstr-theranostics-roadmap/"}],"isotope":[{"id":"ac-225","kind":"isotope","name":"Actinium-225","route":"/isotopes/ac-225/"},{"id":"ga-67","kind":"isotope","name":"Gallium-67","route":"/isotopes/ga-67/"},{"id":"in-111","kind":"isotope","name":"Indium-111","route":"/isotopes/in-111/"},{"id":"pb-212","kind":"isotope","name":"Lead-212","route":"/isotopes/pb-212/"},{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"}],"technology":[{"id":"actinium-225-supply","kind":"technology","name":"Actinium-225 supply: thorium stocks, accelerators and radium targets","route":"/technologies/actinium-225-supply/"},{"id":"lu177-radioligand-therapy","kind":"technology","name":"Lutetium-177 radioligand therapy","route":"/technologies/lu177-radioligand-therapy/"},{"id":"mibg-theranostics","kind":"technology","name":"MIBG imaging and 131I-MIBG therapy","route":"/technologies/mibg-theranostics/"},{"id":"prrt","kind":"technology","name":"Peptide receptor radionuclide therapy (PRRT)","route":"/technologies/prrt/"},{"id":"pet","kind":"technology","name":"PET (positron emission tomography)","route":"/technologies/pet/"},{"id":"pet-ct","kind":"technology","name":"PET/CT","route":"/technologies/pet-ct/"},{"id":"radioembolisation-tare","kind":"technology","name":"Radioembolisation (TARE / SIRT, yttrium-90)","route":"/technologies/radioembolisation-tare/"},{"id":"radionuclide-parp-combination","kind":"technology","name":"Radioligand plus DNA-repair inhibitor combinations","route":"/technologies/radionuclide-parp-combination/"},{"id":"radioligand-therapy","kind":"technology","name":"Radioligand therapy (beta emitters)","route":"/technologies/radioligand-therapy/"},{"id":"radiopharmaceutical-gmp-release","kind":"technology","name":"Radiopharmaceutical GMP and releasing a drug that decays","route":"/technologies/radiopharmaceutical-gmp-release/"},{"id":"research-reactor-isotope-production","kind":"technology","name":"Research reactors for medical isotopes (Mo-99, Lu-177, I-131)","route":"/technologies/research-reactor-isotope-production/"},{"id":"sstr-pet","kind":"technology","name":"Somatostatin receptor PET (68Ga/64Cu-DOTATATE)","route":"/technologies/sstr-pet/"},{"id":"spect-ct","kind":"technology","name":"SPECT/CT","route":"/technologies/spect-ct/"},{"id":"targeted-alpha-therapy","kind":"technology","name":"Targeted alpha therapy","route":"/technologies/targeted-alpha-therapy/"}],"target":[{"id":"dll3","kind":"target","name":"DLL3","route":"/targets/dll3/"},{"id":"sstr2","kind":"target","name":"Somatostatin receptor 2","route":"/targets/sstr2/"}],"drug":[{"id":"itm-11","kind":"drug","name":"177Lu-edotreotide","route":"/drugs/itm-11/"},{"id":"alphamedix","kind":"drug","name":"212Pb-DOTAMTATE","route":"/drugs/alphamedix/"},{"id":"ryz101","kind":"drug","name":"Actinium-225 DOTATATE","route":"/drugs/ryz101/"},{"id":"cabozantinib","kind":"drug","name":"Cabozantinib","route":"/drugs/cabozantinib/"},{"id":"cu-64-dotatate","kind":"drug","name":"Copper-64 dotatate","route":"/drugs/cu-64-dotatate/"},{"id":"everolimus","kind":"drug","name":"Everolimus","route":"/drugs/everolimus/"},{"id":"f-18-fdopa","kind":"drug","name":"Fluorodopa F-18","route":"/drugs/f-18-fdopa/"},{"id":"ga68-dotatate","kind":"drug","name":"Gallium-68 DOTATATE (and Cu-64 DOTATATE)","route":"/drugs/ga68-dotatate/"},{"id":"ga-68-dotatoc","kind":"drug","name":"Gallium-68 edotreotide (DOTATOC)","route":"/drugs/ga-68-dotatoc/"},{"id":"in-111-pentetreotide","kind":"drug","name":"Indium-111 pentetreotide","route":"/drugs/in-111-pentetreotide/"},{"id":"iobenguane-i-131","kind":"drug","name":"Iobenguane I-131 (therapeutic)","route":"/drugs/iobenguane-i-131/"},{"id":"pb-212-vmt-alpha-net","kind":"drug","name":"Lead-212 VMT-alpha-NET","route":"/drugs/pb-212-vmt-alpha-net/"},{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","route":"/drugs/lutathera/"},{"id":"lu-177-dotatate-generic","kind":"drug","name":"Lutetium-177 dotatate (radioligand equivalent)","route":"/drugs/lu-177-dotatate-generic/"},{"id":"sunitinib","kind":"drug","name":"Sunitinib","route":"/drugs/sunitinib/"}],"company":[{"id":"advanced-accelerator-applications","kind":"company","name":"Advanced Accelerator Applications (Novartis)","route":"/companies/advanced-accelerator-applications/"},{"id":"bms","kind":"company","name":"Bristol Myers Squibb","route":"/companies/bms/"},{"id":"evergreen-theragnostics","kind":"company","name":"Evergreen Theragnostics","route":"/companies/evergreen-theragnostics/"},{"id":"itm","kind":"company","name":"ITM Isotope Technologies Munich","route":"/companies/itm/"},{"id":"molecular-targeting-technologies","kind":"company","name":"Molecular Targeting Technologies","route":"/companies/molecular-targeting-technologies/"},{"id":"novartis","kind":"company","name":"Novartis","route":"/companies/novartis/"},{"id":"orano-med","kind":"company","name":"Orano Med","route":"/companies/orano-med/"},{"id":"perspective-therapeutics","kind":"company","name":"Perspective Therapeutics","route":"/companies/perspective-therapeutics/"},{"id":"pfizer","kind":"company","name":"Pfizer (incl. Seagen)","route":"/companies/pfizer/"},{"id":"point-biopharma","kind":"company","name":"POINT Biopharma","route":"/companies/point-biopharma/"},{"id":"radiomedix","kind":"company","name":"RadioMedix","route":"/companies/radiomedix/"},{"id":"rayzebio","kind":"company","name":"RayzeBio (BMS)","route":"/companies/rayzebio/"},{"id":"sinotau-pharmaceutical","kind":"company","name":"Sinotau Pharmaceutical","route":"/companies/sinotau-pharmaceutical/"}],"institution":[{"id":"erasmus-mc","kind":"institution","name":"Erasmus MC Cancer Institute","route":"/institutions/erasmus-mc/"},{"id":"heidelberg-nct","kind":"institution","name":"Heidelberg University Hospital / NCT / DKFZ","route":"/institutions/heidelberg-nct/"},{"id":"inselspital-bern","kind":"institution","name":"Inselspital, Bern University Hospital / University Cancer Center Inselspital","route":"/institutions/inselspital-bern/"},{"id":"irst-meldola","kind":"institution","name":"IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)","route":"/institutions/irst-meldola/"},{"id":"mskcc","kind":"institution","name":"Memorial Sloan Kettering Cancer Center","route":"/institutions/mskcc/"},{"id":"royal-marsden","kind":"institution","name":"The Royal Marsden","route":"/institutions/royal-marsden/"},{"id":"tum-munich","kind":"institution","name":"TUM Klinikum rechts der Isar / CCC München","route":"/institutions/tum-munich/"},{"id":"usb-basel","kind":"institution","name":"University Hospital Basel / Tumour Centre","route":"/institutions/usb-basel/"},{"id":"uk-duesseldorf","kind":"institution","name":"University Hospital Düsseldorf / CIO Düsseldorf","route":"/institutions/uk-duesseldorf/"},{"id":"uppsala-akademiska","kind":"institution","name":"Uppsala University Hospital / Uppsala University","route":"/institutions/uppsala-akademiska/"},{"id":"essen-wtz","kind":"institution","name":"West German Cancer Center (WTZ), University Hospital Essen","route":"/institutions/essen-wtz/"}],"term":[{"id":"alpha-vs-beta","kind":"term","name":"Alpha vs beta emitters","route":"/terms/alpha-vs-beta/"},{"id":"dosimetry","kind":"term","name":"Dosimetry","route":"/terms/dosimetry/"},{"id":"krenning-score","kind":"term","name":"Krenning score","route":"/terms/krenning-score/"},{"id":"net-grade-ki67","kind":"term","name":"Neuroendocrine tumour grade (Ki-67) and WHO classification","route":"/terms/net-grade-ki67/"},{"id":"prrt-term","kind":"term","name":"PRRT (peptide receptor radionuclide therapy)","route":"/terms/prrt-term/"},{"id":"renal-protection-amino-acids","kind":"term","name":"Renal protection with amino acid co-infusion","route":"/terms/renal-protection-amino-acids/"},{"id":"tare","kind":"term","name":"TARE / SIRT (radioembolisation with yttrium-90)","route":"/terms/tare/"},{"id":"theranostics","kind":"term","name":"Theranostics","route":"/terms/theranostics/"}],"trial":[{"id":"nct06398444","kind":"trial","name":"A Clinical Study of Lutetium[177Lu] Oxodotreotide Injection in Patients With Advanced Neuroendocrine Neoplasms","route":"/trials/nct06398444/"},{"id":"nct05459844","kind":"trial","name":"A Study Comparing Treatment With Lutetium[177Lu] Oxodotreotide Injection to Octreotide LAR in Patients With GEP-NETs","route":"/trials/nct05459844/"},{"id":"nct07129252","kind":"trial","name":"A Study to Investigate Safety and Effectiveness of CRN09682 in Participants With SST2-Expressing NENs and Other Solid Tumors","route":"/trials/nct07129252/"},{"id":"action-1","kind":"trial","name":"ACTION-1","route":"/trials/action-1/"},{"id":"alphamedix-02","kind":"trial","name":"ALPHAMEDIX-02","route":"/trials/alphamedix-02/"},{"id":"cabinet","kind":"trial","name":"CABINET (Alliance A021602)","route":"/trials/cabinet/"},{"id":"compete","kind":"trial","name":"COMPETE","route":"/trials/compete/"},{"id":"nct04919226","kind":"trial","name":"Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE","route":"/trials/nct04919226/"},{"id":"netter-1","kind":"trial","name":"NETTER-1","route":"/trials/netter-1/"},{"id":"radiant-3-4","kind":"trial","name":"RADIANT-3 and RADIANT-4","route":"/trials/radiant-3-4/"},{"id":"nct07278479","kind":"trial","name":"Study of [212Pb]Pb-DOTAM-MAM279 ([212Pb]Pb-MP0712) in Patients With Small Cell Lung Cancer and Other DLL3 Expressing Solid Tumors","route":"/trials/nct07278479/"},{"id":"nct03972488","kind":"trial","name":"Study to Evaluate the Efficacy and Safety of Lutathera in Patients With Grade 2 and Grade 3 Advanced GEP-NET","route":"/trials/nct03972488/"},{"id":"nct05636618","kind":"trial","name":"Targeted Alpha-Particle Therapy for Advanced Somatostatin Receptor Type 2 (SSTR2) Positive Tumors","route":"/trials/nct05636618/"}],"idea":[{"id":"idea-net-dosimetry-prrt","kind":"idea","name":"Dosimetry-personalised PRRT instead of four fixed cycles","route":"/ideas/idea-net-dosimetry-prrt/"},{"id":"idea-net-antagonist-ligands","kind":"idea","name":"SSTR antagonist radioligands to increase tumour dose","route":"/ideas/idea-net-antagonist-ligands/"}],"indication":[{"id":"grade-3-net","kind":"indication","name":"Grade 3 well-differentiated neuroendocrine tumour","route":"/indications/grade-3-net/"},{"id":"lung-net","kind":"indication","name":"Lung neuroendocrine tumours (typical and atypical carcinoid)","route":"/indications/lung-net/"},{"id":"multiple-endocrine-neoplasia","kind":"indication","name":"Multiple endocrine neoplasia syndromes (MEN1, MEN2, MEN4)","route":"/indications/multiple-endocrine-neoplasia/"},{"id":"pancreatic-net","kind":"indication","name":"Pancreatic neuroendocrine tumours","route":"/indications/pancreatic-net/"},{"id":"small-intestinal-net","kind":"indication","name":"Small intestinal neuroendocrine tumours","route":"/indications/small-intestinal-net/"}],"person":[{"id":"emily-bergsland","kind":"person","name":"Emily K. Bergsland","route":"/people/emily-bergsland/"},{"id":"jonathan-strosberg","kind":"person","name":"Jonathan R. Strosberg","route":"/people/jonathan-strosberg/"},{"id":"ken-herrmann","kind":"person","name":"Ken Herrmann","route":"/people/ken-herrmann/"},{"id":"paola-anna-erba","kind":"person","name":"Paola Anna Erba","route":"/people/paola-anna-erba/"},{"id":"richard-baum","kind":"person","name":"Richard P. Baum","route":"/people/richard-baum/"},{"id":"simron-singh","kind":"person","name":"Simron Singh","route":"/people/simron-singh/"}],"bottleneck":[{"id":"b-manufacturing-cell-therapy","kind":"bottleneck","name":"Manufacturing cost and time for living and radioactive medicines","route":"/bottlenecks/b-manufacturing-cell-therapy/"},{"id":"b-site-readiness-referral","kind":"bottleneck","name":"Site readiness and referral pathway delays","route":"/bottlenecks/b-site-readiness-referral/"},{"id":"b-dose-optimisation","kind":"bottleneck","name":"Wrong doses","route":"/bottlenecks/b-dose-optimisation/"}],"paper":[{"id":"paper-netter-2-lancet-2024","kind":"paper","name":"NETTER-2: lutetium-177 dotatate as first treatment for higher-grade gastroenteropancreatic neuroendocrine tumours","route":"/key-papers/paper-netter-2-lancet-2024/"},{"id":"paper-baum-prrt-1048-patients-oncotarget-2018","kind":"paper","name":"Results and adverse events of personalised peptide receptor radionuclide therapy in 1048 patients with neuroendocrine neoplasms","route":"/key-papers/paper-baum-prrt-1048-patients-oncotarget-2018/"}],"section":[{"id":"f-dosimetry","kind":"section","name":"Dosimetry","route":"/fronts/f-dosimetry/"},{"id":"f-molecular-imaging","kind":"section","name":"Molecular imaging","route":"/fronts/f-molecular-imaging/"},{"id":"f-radioligand-therapy","kind":"section","name":"Radioligand therapy","route":"/fronts/f-radioligand-therapy/"},{"id":"f-alpha-therapy","kind":"section","name":"Targeted alpha therapy","route":"/fronts/f-alpha-therapy/"}]}}