Do you have a preferred therapy for patients with metastatic gastroenteropancreatic (GEP) neuroendocrine tumors that progressed through octreotide and PRRT?

As we gain more experience with PRRT, this is a more and more common scenario in the clinic. I am going to restrict this discussion to grade 1/2 GEP-NETs. There are a few things I consider when a patient progresses on PRRT. The first is the duration of response they achieved on the initial 4 doses o...

I usually make sure that we get the anatomical scan (either triphasic CT or MRI better if mainly liver mets) at least 12 weeks after the last PRRT to ensure we are not dealing with pseudo progression. If we confirm it is real progression, I agree the time frame of response vs progression and positiv...