The NETTER-2 phase 3 trial has provided groundbreaking data on GEP-NETs
Sergio Cifuentes Canaval, Cancer Research Project Manager at CENEIT Mexico, on LinkedIn about a study by Simron Singh et al.
“Exciting news in the fight against advanced gastroenteropancreatic neuroendocrine tumours (GEP-NETs)!
The NETTER-2 phase 3 trial has shown that 177Lu-Dotatate plus long-acting octreotide significantly improves progression-free survival compared to high-dose octreotide alone.
This breakthrough offers new hope for patients who have long awaited better treatment options.
Kudos to the research teams and participants for paving the way to better outcomes!”
Quoting Sergio Cifuentes Canaval’s post:
“77Lu-DOTA-TATE Plus Long-Acting Octreotide vs High-Dose Long-Acting Octreotide for Advanced GEP-NETs.
The NETTER-2 phase 3 trial has provided groundbreaking data on the treatment of newly diagnosed, advanced grade 2-3, well-differentiated, GEP-NETs.
-NETTER-2 was an open-label, randomized, parallel-group, superiority trial conducted across 45 centers.
Participants: The trial enrolled 226 patients aged ≥15 years with newly diagnosed, higher-grade (2-3) well-differentiated, somatostatin receptor-positive GEP-NETs. Grade 2 tumors had a Ki67 index between 10-20%, while grade 3 tumors had a Ki67 index between 20-55%.
Randomization: Patients were randomly assigned in a 2:1 ratio to receive either four cycles of intravenous 177Lu-Dotatate plus 30 mg intramuscular octreotide long-acting repeatable (LAR) every 4 weeks (177Lu-Dotatate group), or 60 mg octreotide LAR every 4 weeks (control group).
Treatment: In the 177Lu-Dotatate group, patients received four cycles of 177Lu-Dotatate at 8-week intervals, followed by maintenance therapy with octreotide 30 mg LAR every 4 weeks.
Key Finding: PFS: Patients in the 177Lu-Dotatate mPFS of 22.8 months vs 8.5 months in the control group (HR 0.276, p<0.0001).
My Analysis –
Practice-Changing: The substantial improvement in PFS with 177Lu-Dotatate represents a paradigm shift in the treatment of advanced GEP-NETs. Clinicians should consider incorporating this regimen as the new standard of care for patients advanced grade 2-3, well-differentiated, GEP-NETs.
Applicability: While the results are compelling, the study’s applicability is primarily for patients with newly diagnosed, well-differentiated, grade 2-3, somatostatin receptor-positive GEP-NETs.
It’s crucial for practitioners to ensure proper patient selection based on these criteria to optimize treatment outcomes.
Future Directions: Future research should focus on understanding the long-term benefits and potential resistance mechanisms to 177Lu-Dotatate therapy.
Additionally, exploring combination strategies with other therapeutic agents could further enhance efficacy and address unmet needs in this patient population.
The NETTER-2 study sets a new benchmark in the management of advanced GEP-NETs, heralding a new era of personalized oncology treatment.”
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