[177Lu]Lu-edotreotide versus everolimus for gastroenteropancreatic neuroendocrine tumours (COMPETE): a phase 3, multicentre, randomised, open-label, superiority trial.

Walter T, Jann H, Ansquer C, Deshayes E, Garcia-Carbonero R, Teulé A, Baum RP, Verberne HJ, Ćwikła JB, Srirajaskanthan R, de Mestier L, …, Capdevila J · 2026 · Lancet · Atlas ID WALTER2026

What this study shows

Phase 3 open-label RCT (n=309, 2:1): 177Lu-edotreotide gave longer PFS than everolimus (23.9 vs 14.1 months; HR 0.67) with fewer grade 3-4 treatment-related adverse events (18% vs 40%), supporting PRRT in early lines for progressive SSTR-positive GEP-NETs.

Abstract

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Peptide receptor radionuclide and targeted therapy are both approved treatment options for patients with metastatic gastroenteropancreatic neuroendocrine tumours (GEP NETs), but clinical evidence for preferred sequencing is scarce. The COMPETE trial evaluated the efficacy and harms of peptide receptor radionuclide therapy ([177Lu]Lu-edotreotide) versus targeted molecular therapy (everolimus) in patients with advanced, progressive, somatostatin receptor-positive GEP NETs.

Read the full abstract on PubMed →

At a glance

Evidence type	H Human study Marked H because it is direct evidence from a human clinical trial or human cohort; the code names the kind of study, not its quality -- a small, well-run trial is still H.
Study type	2 - Human Clinical Trial
Model system	Human RCT
Journal	Lancet
Year	2026
Peer reviewed	Yes
Record last updated	2026-10-01
Source	DOI 10.1016/S0140-6736(26)00604-5 · PMID 42392118

Extracted findings

These fields were extracted from the paper with AI assistance and have not been checked against the source. Read them as a pointer into the paper, not as curated claims; where they disagree with the curated summary above, the curated summary stands.

Intervention	Everolimus (mTOR inhibitor) vs [177Lu]Lu-edotreotide
Target	mTORC1
Model	Human
Effect	PRRT ([177Lu]Lu-edotreotide) gave longer PFS than everolimus, with fewer grade 3-4 treatment-related adverse events, in treatment-naive or pretreated SSTR-positive GEP-NETs

In the Atlas

Cite this paper

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Walter, T., Jann, H., Ansquer, C., Deshayes, E., Garcia-Carbonero, R., Teulé, A., Baum, R. P., Verberne, H. J., Ćwikła, J. B., Srirajaskanthan, R., de Mestier, L., Grana, C. M., Buck, A., Hörsch, D., Pavel, M., Dierickx, L. O., Michael, M., Strosberg, J., Kollár, A., Jimenez-Fonseca, P., Rinke, A., Del Olmo-García, M., Flaus, A., Hernando, J., Kluge, A., Breuninger, M., Melnyk, S., Zhernosekov, K., & Capdevila, J. (2026). [177Lu]Lu-edotreotide versus everolimus for gastroenteropancreatic neuroendocrine tumours (COMPETE): a phase 3, multicentre, randomised, open-label, superiority trial. Lancet. https://doi.org/10.1016/S0140-6736(26)00604-5

@article{WALTER2026,
  author       = {Walter, T. and Jann, H. and Ansquer, C. and Deshayes, E. and Garcia-Carbonero, R. and Teulé, A. and Baum, R. P. and Verberne, H. J. and Ćwikła, J. B. and Srirajaskanthan, R. and de Mestier, L. and Grana, C. M. and Buck, A. and Hörsch, D. and Pavel, M. and Dierickx, L. O. and Michael, M. and Strosberg, J. and Kollár, A. and Jimenez-Fonseca, P. and Rinke, A. and Del Olmo-García, M. and Flaus, A. and Hernando, J. and Kluge, A. and Breuninger, M. and Melnyk, S. and Zhernosekov, K. and Capdevila, J.},
  title        = {{[177Lu]Lu-edotreotide versus everolimus for gastroenteropancreatic neuroendocrine tumours (COMPETE): a phase 3, multicentre, randomised, open-label, superiority trial}},
  journal      = {Lancet},
  year         = {2026},
  doi          = {10.1016/S0140-6736(26)00604-5},
  note         = {PMID: 42392118},
}

Cite this Atlas record

The record is the Atlas's own work — the evidence label, the extracted findings and the links. It is cited as part of the dataset, not as the paper.

Barton, O. (2026). Oliver's mTOR Atlas (record WALTER2026) [Data set]. https://mtor-atlas.org/study/WALTER2026/ · Dataset DOI 10.5281/zenodo.22059963

@misc{atlas_WALTER2026,
  author       = {Barton, Oliver},
  title        = {{Oliver's mTOR Atlas}, record WALTER2026},
  howpublished = {Data set},
  year         = {2026},
  url          = {https://mtor-atlas.org/study/WALTER2026/},
  doi          = {10.5281/zenodo.22059963}
}

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