¹⁷⁷Lu-edotreotide vs everolimus for gastroenteropancreatic neuroendocrine tumors (COMPETE): a phase 3, randomized, open-label, superiority trial

In this OncLive Rapid Readout, Jonathan Strosberg, MD, of Moffitt Cancer Center, reviews results from COMPETE, a phase 3, randomized, open-label superiority trial comparing ¹⁷⁷Lu-edotreotide with everolimus in patients with advanced, progressive, somatostatin receptor–positive, grade 1 or 2 gastroenteropancreatic neuroendocrine tumors (GEP-NETs). The trial met its primary endpoint, with ¹⁷⁷Lu-edotreotide significantly prolonging median progression-free survival vs everolimus (23.9 vs 14.1 months; HR, 0.67; 95% CI, 0.48-0.95; P = .022). Objective response rate was also higher (22% vs 4%; P < .0001), with a longer median duration of disease control (27.3 vs 17.2 months). ¹⁷⁷Lu-edotreotide demonstrated a favorable safety profile, with fewer grade 3/4 treatment-related adverse events (18% vs 40%) and fewer discontinuations, and no treatment-related deaths. Strosberg discusses how these findings support peptide receptor radionuclide therapy as a preferred early-line option over everolimus following progression on somatostatin analogue therapy in this patient population.