In France, since the reimbursement of Lutathera®, this treatment is allowed for retreatment if patients still fulfill the criteria of its indication and 4 news cycles could be proposed. However, clinical practices are heterogeneous regarding the number of new cycles and most teams perform only two additional cycles (every 8 weeks). Therefore, the coordinator propose to evaluate the efficacy of two additional cycle of Lutathera® versus active surveillance in patients already retreated with two cycles Lutathera® for a new progression of intestinal neuroendocrine tumor and who previously received the 4 cycles of treatment with a clinical benefit.
Age ≥ 18 years,
Histologically proven intestinal G1 or G2 neuroendocrine tumors (NET),
Patient previously treated with 4 cycles of Lutathera® (defined as "First PRRT"),
Disease control after "First PRRT" ≥ 12 months,
Patient who did not respond (no CR, PR or SD) to "first PRRT".
Radiological progression after two cycles of "Second PRRT" according to RECIST version 1.1,
Grade 4 hematotoxicity and/or nephrotoxicity during the initial PRRT, or unresolved AEs categorized as Grade 2 or higher (as per Common Terminology Criteria for Adverse Events (CTCAE v5.0) from previous PRRT cycles or any other therapy for NET, excluding alopecia and peripheral neuropathy,
Pancreatic NET,