NETTER-1 Phase III Trial suggests Quality of Life Improvements in Patients with Midgut Neuroendocrine Tumors

Objectives: Neuroendocrine tumor progression is associated with decline in quality of life, both due to tumor and hormone-related symptoms. The Phase III NETTER-1 trial randomized patients with advanced, progressive midgut NETs to receive treatment with ¹⁷⁷Lu-DOTATATE (¹⁷⁷Lu; Lutathera) versus high-dose (60 mg) Octreotide LAR (Oct). EORTC questionnaires C30 and GINET21 were assessed during the trial in order to determine the impact of treatment on health-related quality of life (HRQoL).

Methods: Patients completed EORTC QLQ-30 and QLQ-G.I.NET21 questionnaires at baseline and every 12 weeks thereafter until disease progression. Raw scores were converted to a 100-point scale and individual changes from baseline scores were assessed. Clinically relevant (蠅10 point) deterioration/improvement was considered clinically significant.

Results: Clinically and statistically significant improvements in QoL were observed in the ¹⁷⁷Lu arm versus the Oct arm at certain time points in key domains of HRQoL including global health status and diarrhea.

Conclusion: QoL analysis suggests benefit in important domains associated with ¹⁷⁷Lu treatment compared to high-dose octreotide in patients with advanced midgut NETs, and confirms the treatment value of ¹⁷⁷Lu on patient QoL, in addition to the meaningful increase in progression-free survival already reported. Keywords: ¹⁷⁷Lu-DOTATATE, PRRT, NET Quality of Life