# NETTER-1

Source: https://onco.cc/trials/netter-1/  
OnCo record `netter-1` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The trial that made radioligand therapy a standard: a radioactive drug homing to the somatostatin receptor held midgut neuroendocrine tumours in check far longer than high-dose octreotide, and it underpins Lutathera's approvals.

## Summary

NETTER-1, trial NCT01578239 sponsored by Advanced Accelerator Applications and published in the New England Journal of Medicine in 2017, randomised 231 patients with inoperable, progressive, somatostatin receptor-positive midgut neuroendocrine tumours to 177Lu-Dotatate (four cycles, with octreotide) or high-dose octreotide LAR. Progression-free survival at 20 months was 65.2% with 177Lu-Dotatate against 10.8% with octreotide, and the response rate was 18% against 3%. The result supported the 2018 US and EU approvals of Lutathera and made peptide receptor radionuclide therapy the reference treatment after somatostatin analogues.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-04
- Registry id: NCT01578239
- Phase: 3
- Setting: Inoperable, progressive midgut neuroendocrine tumours: 177Lu-Dotatate plus octreotide versus high-dose octreotide LAR
- Sponsor: Advanced Accelerator Applications (Novartis)
- Enrolled: 231
- Result: PFS at 20 months 65.2% vs 10.8% (HR 0.21); ORR 18% vs 3%.
- Outcomes: Progression-free survival at 20 months: 177Lu-Dotatate + octreotide 65.2% vs High-dose octreotide LAR 10.8%, HR 0.21; Objective response rate: 177Lu-Dotatate + octreotide 18% vs High-dose octreotide LAR 3%

## Sources

- ClinicalTrials.gov NCT01578239: https://clinicaltrials.gov/study/NCT01578239
- Strosberg et al., Phase 3 trial of 177Lu-Dotatate for midgut neuroendocrine tumours (NEJM 2017): https://doi.org/10.1056/NEJMoa1607427

## Connected records

- cancers: [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Pancreatic neuroendocrine tumours](https://onco.cc/cancers/pancreatic-net/), [Small intestinal neuroendocrine tumours](https://onco.cc/cancers/small-intestinal-net/)
- technologies: [Peptide receptor radionuclide therapy (PRRT)](https://onco.cc/technologies/prrt/)
- targets: [Somatostatin receptor 2](https://onco.cc/targets/sstr2/)
- drugs: [Lutetium-177 dotatate](https://onco.cc/drugs/lutathera/), [Somatostatin analogues (octreotide, lanreotide)](https://onco.cc/drugs/octreotide-lanreotide/)
- companies: [Novartis](https://onco.cc/companies/novartis/)
- ideas: [Dosimetry-personalised PRRT instead of four fixed cycles](https://onco.cc/ideas/idea-net-dosimetry-prrt/)
- key papers: [NETTER-1: 177Lu-Dotatate for midgut neuroendocrine tumours progressing on octreotide](https://onco.cc/key-papers/paper-netter-1-nejm-2017/)

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