Teaching points:

• Therapy with 177Lutetium DOTA TATE can be useful for inoperable, metastatic GEP NETs.
• The rate of complete responses obtained by Kwekkeboom et al was only 2% in patients treated with 177Lu-DOTA TATE. They reported partial responses, minor responses, stable disease and progressive disease, respectively, in 26%, 19%, 35% and 15% of their patients.
• Treatment tolerance was good, significant reduction of symptoms was obtained and 2-yr survival rate was 76 ± 16%.
• Predictors of good response include: high uptake of lesions in somatostatin receptor scintigraphy and Karnofky’s performance status > 70%.
• Predictors of poor prognosis include: massive liver involvement, bone metastases and Karnofky’s index 70%.