Related Experiment Video
Updated: Jan 18, 2026
An Orthotopic Sciatic Nerve Xenograft for Neurofibromatosis Type 1 Neurofibromas
Published on: October 10, 2025
My burning issues in neuroendocrine tumours (NET)
Barbara Kiesewetter1,2, Markus Raderer1,2
11Department of Internal Medicine I, Division of Oncology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Abstract:
Several compounds have recently been approved for the systemic treatment of advanced well-differentiated neuroendocrine tumours (NET) of gastroenteropancreatic (GEP) or lung origin. Based on the PROMID and CLARINET trials, somatostatin analogues (SSA) are the preferred first-line approach for all GEP-NET and offer-in addition to antiproliferative effects-durable symptomatic relief for hormonally active tumours. The mTOR inhibitor everolimus has been approved for progressive GEP- and lung-NET and is a widely used drug in this setting. Furthermore, recent results have underlined the high efficacy of somatostatin-receptor targeting radionuclide therapy (PRRT) in somatostatin-receptor positive midgut tumours and PRRT is now considered standard treatment for midgut-NET progressing on SSA. The optimal application of PRRT in somatostatin receptor positive NET with non-midgut site is currently an issue of discussion and should be decided on an individually basis in multidisciplinary boards. Following new insights in the genetic landscape of NET, "hot topics" in recent months include optimal treatment of the recently defined NET G3 and preliminary data on immunotherapy.
Insights
New treatments for advanced neuroendocrine tumors (NET) include somatostatin analogues (SSA) as first-line therapy and radionuclide therapy (PRRT) for midgut NET. Research is ongoing for NET G3 and immunotherapy.
Area of Science:
- Oncology
- Nuclear Medicine
- Pharmacology
Background:
- Advanced well-differentiated neuroendocrine tumors (NET) of gastroenteropancreatic (GEP) or lung origin have seen recent therapeutic advancements.
- Somatostatin analogues (SSA) are established as first-line treatment for GEP-NET, offering antiproliferative and symptomatic benefits.
- Everolimus, an mTOR inhibitor, is approved for progressive GEP- and lung-NET.
Purpose of the Study:
- To review current systemic treatment options for advanced neuroendocrine tumors.
- To discuss the role of somatostatin analogues (SSA), everolimus, and peptide receptor radionuclide therapy (PRRT).
- To highlight emerging areas of research including NET G3 and immunotherapy.
Main Methods:
- Review of pivotal clinical trials (PROMID, CLARINET) for SSA efficacy.
- Analysis of recent data on everolimus use in GEP- and lung-NET.
- Evaluation of current evidence and expert opinion on PRRT for midgut and non-midgut NET.
Main Results:
- SSA are the preferred first-line treatment for GEP-NET, providing antiproliferative and symptomatic relief.
- PRRT is a standard treatment for midgut-NET progressing on SSA, with ongoing discussion regarding its use in non-midgut NET.
- Optimal treatment strategies for NET G3 and the potential of immunotherapy are active areas of investigation.
Conclusions:
- Current systemic therapies for advanced NET include SSA, everolimus, and PRRT, with specific indications based on tumor origin and progression.
- PRRT is highly effective for midgut-NET and its application in other NET sites requires individualized multidisciplinary assessment.
- Future research directions focus on refining treatment for NET G3 and exploring the efficacy of immunotherapy in NET.
Related Concept Videos
02:18Cancer
02:17The Tumor Microenvironment
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists