A major phase 3 trial called COMPETE compared two approved treatments for advanced gastroenteropancreatic neuroendocrine tumors: a radioligand therapy called lutetium-177 edotreotide versus the mTOR inhibitor everolimus. Across 309 patients from 14 countries, those receiving the radioligand therapy lived significantly longer without disease progression — nearly 24 months compared to 14 months for everolimus. The radioligand also produced fewer severe side effects: only 18% of patients experienced grade 3–4 adverse events versus 40% on everolimus. No treatment-related deaths occurred in either group. These results support moving radioligand therapy earlier in the treatment sequence for patients with somatostatin receptor-positive GEP NETs, potentially reshaping clinical practice guidelines for this increasingly diagnosed cancer type.
