title: GEPNETs update: Radionuclide therapy in neuroendocrine tumors.
abstract: 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.
authors.affiliation: Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA w.vanderzwan@erasmusmc.nl.
authors.forename: Wouter A
authors.initials: WA
authors.lastname: van der Zwan
authors.affiliation: Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bodei
authors.affiliation: Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Mueller-Brand
authors.affiliation: Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Wouter W
authors.initials: WW
authors.lastname: de Herder
authors.affiliation: Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Larry K
authors.initials: LK
authors.lastname: Kvols
authors.affiliation: Department of Nuclear MedicineErasmus MC, University Medical Center, s-Gravendijkwal 230, 3015CE Rotterdam, The NetherlandsDepartment of Nuclear MedicineEuropean Institute of Oncology, Milan, ItalyDepartment of Nuclear MedicineUniversity Hospital Basel, Basel, SwitzerlandDepartment of GI OncologyH. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
authors.forename: Dik J
authors.initials: DJ
authors.lastname: Kwekkeboom
mesh_terms: D000818:Animals; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D011868:Radioisotopes / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D018000:Receptors, Peptide / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D015996:Survival Rate / Q000639:trends
chemical_list: D011868:Radioisotopes; D019275:Radiopharmaceuticals; D018000:Receptors, Peptide