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Neuroendocrine Tumour — SCE Medical Oncology MCQ

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HardGI CancersNeuroendocrine TumourSCE Medical Oncology

A patient with a progressive, well-differentiated grade 2 ileal neuroendocrine tumour has Ki-67 8%, strong homogeneous somatostatin-receptor uptake exceeding liver, adequate marrow reserve and eGFR 72 mL/min despite long-acting octreotide. Which next treatment is most specifically supported by NICE?

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Correct answer: E — Lutetium-177 oxodotreotide peptide receptor radionuclide therapy

The tumour is progressive, well differentiated and strongly somatostatin-receptor positive with adequate renal and marrow function. This is the phenotype addressed by NICE TA539 for lutetium-177 oxodotreotide. Sunitinib is a pancreatic-NET option, while platinum-etoposide is reserved for poorly differentiated/high-grade disease.

Reference: NICE TA539 lutetium-177 dotatate: recommendations (Published August 2018): https://www.nice.org.uk/guidance/ta539/chapter/1-Recommendations