Phase 3 RCT (COMPETE, Lancet 2026) found [177Lu]Lu-edotreotide (PRRT) had superior progression-free survival vs everolimus (mTOR inhibitor) in advanced somatostatin receptor-positive GEP-NETs, establishing PRRT as preferred over mTOR inhibition in this setting.
| Evidence tier | B Direct human evidence |
| Study type | 2 - Human Clinical Trial |
| Model system | Human RCT |
| Journal | Lancet |
| Year | 2026 |
| Peer reviewed | Yes |
| Source | DOI 10.1016/S0140-6736(26)00604-5 |
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 ([Lu]Lu-edotreotide) versus targeted molecular therapy (everolimus) in patients with advanced, progressive, somatostatin receptor-positive GEP NETs.
| Intervention | Everolimus (mTOR inhibitor) vs [177Lu]Lu-edotreotide |
| Target | mTORC1 |
| Model | Human |
| Effect | PRRT superior to everolimus on PFS; mTOR inhibition inferior as first-line in GEP-NETs |