¹⁷⁷Lu-DOTATATE (SSTR-targeted PRRT) extends PFS ~14 months vs high-dose octreotide in 1L G2–G3 GEP-NETs

¹⁷⁷Lu-DOTATATE is a radiolabeled somatostatin analog (PRRT) that targets somatostatin receptor–positive (SSTR+) disease; in the open-label, randomized Phase 3 NETTER-2 trial (NCT03972488), previously untreated advanced, well-differentiated G2–G3 (Ki-67 10–55%) GEP-NET patients were randomized 2:1 to four cycles of ¹⁷⁷Lu-DOTATATE + octreotide LAR vs high-dose octreotide LAR 60 mg. In the overall population (n=226), median PFS was 22.8 months vs 8.5 months (HR 0.276; p<0.0001), and subgroup HRs were consistent across grade and origin (e.g., G2 HR 0.31; G3 HR 0.27; pancreatic HR 0.34; GI HR 0.23), with ORR improved across subgroups; the control arm’s ~8–9 month PFS is broadly in line with “intensified SSA” benchmarks reported after SSA progression in other datasets, underscoring that the size of benefit here is mainly driven by earlier PRRT use rather than an unusually weak control.