{"entity":{"id":"paper-strosberg-netter1-qol-jco-2018","kind":"paper","name":"Health-related quality of life in the NETTER-1 trial of 177Lu-Dotatate","aka":[],"tldr":"In people with a slow-growing gut cancer, the radioactive treatment lutetium-177 dotatate did not just shrink tumours for longer - it also kept their day-to-day quality of life, including energy, pain and diarrhoea, better for much longer than the older drug it was compared with.","summary":"This is the health-related quality-of-life (HRQoL) analysis of NETTER-1, the phase 3 trial that established 177Lu-Dotatate (Lutathera) for progressive midgut neuroendocrine tumours. Patients (117 on 177Lu-Dotatate, 114 on high-dose octreotide) completed the EORTC QLQ-C30 and GI.NET-21 questionnaires at baseline and every 12 weeks. Time to deterioration (TTD), defined as a fall of 10 points or more from baseline in a domain, was compared between arms by intention to treat.\n\nTTD was significantly longer with 177Lu-Dotatate across every domain tested: global health status (HR 0.406), physical functioning (HR 0.518), role functioning (HR 0.580), fatigue (HR 0.621), pain (HR 0.566), diarrhoea (HR 0.473), disease-related worries (HR 0.572) and body image (HR 0.425). The difference in median TTD was large in absolute terms - 28.8 months versus 6.1 months for global health status, and 25.2 versus 11.5 months for physical functioning.\n\nBecause NETTER-1's primary endpoint (progression-free survival) had already shown a large benefit, this paper mattered for showing the benefit was not bought at the cost of how patients felt day to day - in every domain measured, 177Lu-Dotatate patients did the same or better than those on high-dose octreotide, never worse. It is frequently cited alongside the primary NETTER-1 report to support PRRT's tolerability case to patients and payers.","asOf":"2026-09-22","links":[{"label":"PubMed: NETTER-1 quality-of-life analysis (JCO 2018)","url":"https://pubmed.ncbi.nlm.nih.gov/29878866/"},{"label":"ASCO Publications: full text","url":"https://ascopubs.org/doi/10.1200/JCO.2018.78.5865"}],"tags":["neuroendocrine tumours","PRRT","quality of life"],"related":["netter-1","paper-netter-1-nejm-2017","lutathera","prrt","small-intestinal-net","jonathan-strosberg","richard-baum","lu-177"],"indications":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"JCO","year":2018,"doi":"10.1200/JCO.2018.78.5865","pmid":"29878866","authors":"Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, et al.","paperType":"rct","findings":["Time to QoL deterioration (10-point fall) was significantly longer with 177Lu-Dotatate than high-dose octreotide across all measured domains.","Global health status: median TTD 28.8 months (177Lu-Dotatate) vs 6.1 months (octreotide); HR 0.406, p<0.001.","Physical functioning: median TTD 25.2 vs 11.5 months; HR 0.518.","Diarrhoea (HR 0.473), fatigue (HR 0.621) and pain (HR 0.566) all deteriorated significantly later on 177Lu-Dotatate."],"whatItMeans":"People treated with the radioactive drug lutetium-177 dotatate kept feeling well for much longer - years rather than months, in several measures - than people on the standard high-dose hormone injection, on top of the tumour-control benefit already shown.","caveats":["Quality-of-life data are patient-reported and unblinded (the trial was open-label), which can bias favourable results toward the novel treatment.","Questionnaires were completed only until disease progression, so long-term quality of life beyond that point is not captured here.","This is a secondary/exploratory endpoint analysis of NETTER-1, not an independently powered trial."],"changedPractice":true,"participants":231},"route":"/key-papers/paper-strosberg-netter1-qol-jco-2018/","neighbours":{"trial":[{"id":"netter-1","kind":"trial","name":"NETTER-1","route":"/trials/netter-1/"}],"paper":[{"id":"paper-netter-1-nejm-2017","kind":"paper","name":"NETTER-1: 177Lu-Dotatate for midgut neuroendocrine tumours progressing on octreotide","route":"/key-papers/paper-netter-1-nejm-2017/"}],"drug":[{"id":"lutathera","kind":"drug","name":"Lutetium-177 dotatate","route":"/drugs/lutathera/"}],"technology":[{"id":"prrt","kind":"technology","name":"Peptide receptor radionuclide therapy (PRRT)","route":"/technologies/prrt/"}],"indication":[{"id":"small-intestinal-net","kind":"indication","name":"Small intestinal neuroendocrine tumours","route":"/indications/small-intestinal-net/"}],"person":[{"id":"jonathan-strosberg","kind":"person","name":"Jonathan R. Strosberg","route":"/people/jonathan-strosberg/"},{"id":"richard-baum","kind":"person","name":"Richard P. Baum","route":"/people/richard-baum/"}],"isotope":[{"id":"lu-177","kind":"isotope","name":"Lutetium-177","route":"/isotopes/lu-177/"}]}}