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Neuroendocrine
tumor (NET)
treatment guidelines

For full LUTATHERA® safety information please refer to your local Summary of Product Characteristics or prescribing information via adacap.com/our-products/.

Treatment guidelines

International guidelines recommend peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE* after progression on first-line somatostatin analogs (SSAs)1-5

The table below summarizes recommendations from medical societies on the sequencing of 177Lu-DOTATATE* for the treatment of GEP-NETs. Click on the guidelines to read the recommendations.

Molecular imaging and theranostics in neuroendocrine neoplasms+

Consensus on molecular imaging and theranostics in neuroendocrine neoplasms1

  • PRRT is recommended as second-line treatment after progression or lack of symptomatic control on SSAs, for patients with nonresectable or disseminated somatostatin receptor (SSTR)-positive gastrointestinal NETs
  • Most panellists (71.4%) chose 177Lu-DOTATATE as their preferred radiopharmaceutical for treating NET patients
Read the full guidelines here

NET, neuroendocrine tumor; PRRT, peptide receptor radionuclide therapy; SSA, somatostatin analog; SSTR, somatostatin receptor.

ENETS+

European Neuroendocrine Tumor Society (ENETS), 20162

  • For midgut NET patients, PRRT with 177Lu-DOTATATE is recommended as a second-line therapy after progression on SSAs
  • For patients with functional, SSTR-positive pancreatic NET (pNET), PRRT with 177Lu-DOTATATE is recommended as a second-line therapy. In low grade, non-functional pNETs, PRRT with 177Lu-DOTATATE is recommended as a third-line therapy
Read the full guidelines here

ENETS, European Neuroendocrine Tumor Society; NET, neuroendocrine tumor; pNET, pancreatic neuroendocrine tumor; SSA, somatostatin analog.

ESMO+

European Society for Medical Oncology (ESMO) – 2020 update3

  • PRRT with 177Lu-DOTATATE is recommended as a second-line therapy in patients with midguts NETs after progression on SSA
  • PRRT with 177Lu-DOTATATE can be considered in both functioning and non-functioning NETs with positive SSTR scintigraphy irrespective of the primary tumor site
Read the full guidelines here

ESMO, European Society for Medical Oncology; NET, neuroendocrine tumor; PRRT, peptide receptor radionuclide therapy; SSA, somatostatin analog; SSTR, somatostatin receptor.

NANETS / SNMMI+

NANETS/SNMMI Consensus Statement on Patient Selection and Appropriate Use of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy, 20204

  • PRRT with 177Lu-DOTATATE should be considered in patients with SSTR-positive midgut NET at time of progression after treatment with first-line SSA therapy (appropriateness score 9/9*)
  • PRRT with 177Lu-DOTATATE should be considered for treatment of patients with progressive pNET (appropriateness score 8/9*)
Read the full guidelines here

*Scores 7 to 9 indicate that the use of the procedure is appropriate for the specific scenario and is generally considered acceptable.
NANETS, North American Neuroendocrine Tumor Society; NET, neuroendocrine tumor; pNET, pancreatic neuroendocrine tumor; PRRT, peptide receptor radionuclide therapy; SNMMI, Society of Nuclear Medicine and Molecular Imaging; SSA, somatostatin analog; SSTR, somatostatin receptor.

NCCN+

US National Comprehensive Cancer Network (NCCN), 20215

  • PRRT with 177Lu-DOTATATE is a category 1* recommended option for use after progression on a SSA in SSTR-positive, progressive midgut NETs
  • PRRT with 177Lu-DOTATATE is a category 2A** recommended option for use after progression on a SSA in SSTR-positive, progressive GEP-NETs other than midgut NETs, including pNETs
Read the full guidelines here

*Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. **Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. GEP-NET, gastroenteropancreatic neuroendocrine tumor; NCCN, National Comprehensive Cancer Network; NET, neuroendocrine tumor; pNET, pancreatic neuroendocrine tumor; SSA, somatostatin analog; SSTR, somatostatin receptor.

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*This is an alternative name for the International Nonproprietary Name used in Europe (lutetium (177Lu) oxodotreotide).
GEP-NET, gastroenteropancreatic neuroendocrine tumor; NET, neuroendocrine tumor; SSA, somatostatin analog.

References: 1. Ambrosini V, Kunikowska J, Baudin E, et al. Consensus on molecular imaging and theranostics in neuroendocrine neoplasms. Eur J Cancer. 2021; 146: 56-73. 2. Pavel M, Toole D, Costa F et al. ENETS Consensus Guidelines Update for the management of Distant Metastatic Disease of Intestinal, Pancreatic, Bronchial Neuroendocrine Neoplasms (NEN) and NEN of Unknown Primary Site. Neuroendocrinology 2016; 103: 172–185. 3. Pavel M, Öberg K, Falconi M et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020; 31(7): 844–860. 4. Hope T, Bodei L, Chan JA et al. NANETS/SNMMI Consensus Statement on Patient Selection and Appropriate Use of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy. J Nucl Med. 2020; 61(2): 222–227. 5. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Neuroendocrine and Adrenal Tumors V.2.2021. © National Comprehensive Cancer Network, Inc. 2021.
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Disclaimer: This is an international website for LUTATHERA® (lutetium (177Lu) oxodotreotide) and is intended for healthcare professionals outside the US. Visit US site. The information on this site is not country-specific, and may contain information that is outside the approved indications in the country in which you are located. Please contact your local AAA representative for the latest information specific to your country. Please find your local summary of product characteristics or prescribing information via adacap.com/our-products/.
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