GEPNETs update: Radionuclide therapy in neuroendocrine tumors

Eur J Endocrinol. 2015 Jan;172(1):R1-8. doi: 10.1530/EJE-14-0488. Epub 2014 Aug 12.


Peptide receptor radionuclide therapy (PRRT) is a promising new treatment modality for inoperable or metastasized gastroenteropancreatic neuroendocrine tumors (GEPNETs) patients. Most studies report objective response rates in 15-35% of patients. Also, outcome in terms of progression free survival (PFS) and overall survival compares very favorably with that for somatostatin analogs, chemotherapy, or new, 'targeted' therapies. They also compare favorably to PFS data for liver-directed therapies. Two decades after the introduction of PRRT, there is a growing need for randomized controlled trials comparing PRRT to 'standard' treatment, that is treatment with agents that have proven benefit when tested in randomized trials. Combining PRRT with liver-directed therapies or with targeted therapies could improve treatment results. The question to be answered, however, is whether a combination of therapies performed within a limited time-span from one another results in a better PFS than a strategy in which other therapies are reserved until after (renewed) tumor progression. Randomized clinical trials comparing PRRT with other treatment modalities should be undertaken to determine the best treatment options and treatment sequelae for patients with GEPNETs.

Publication types

  • Review

MeSH terms

  • Animals
  • Humans
  • Intestinal Neoplasms / diagnosis
  • Intestinal Neoplasms / drug therapy
  • Intestinal Neoplasms / mortality
  • Neuroendocrine Tumors / diagnosis
  • Neuroendocrine Tumors / drug therapy*
  • Neuroendocrine Tumors / mortality
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / drug therapy
  • Pancreatic Neoplasms / mortality
  • Radioisotopes / therapeutic use*
  • Radiopharmaceuticals / therapeutic use
  • Receptors, Peptide / therapeutic use*
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / mortality
  • Survival Rate / trends


  • Radioisotopes
  • Radiopharmaceuticals
  • Receptors, Peptide

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor