Updated 2026:
A more recent, mature publication from the same Australian CONTROL NET programme has confirmed the earlier signal: combining PRRT with CAPTEM produces high response rates, particularly in pancreatic NETs, but at the cost of substantially increased haematologic toxicity and no clear, durable survival advantage strong enough to change guidelines.
Highlights
Efficacy outcomes from PRRT+CAPTEM in NENs remain unclear. PRRT/CAPTEM was feasible and well tolerated in this randomized trial. SBNETS: No PFS difference between PRRT/CAPTEM and PRRT. PNETs: PFS/ORR for PRRT/CAPTEM numerically higher than CAPTEM on extended follow-up. Randomized studies in uncommon tumours are essential to optimise practice.
Interesting conclusion on Pancreatic NET: “The efficacy of CAPTEM/PRRT in pNETs should be tested in a phase III trial”.
Update 2022: Trial complete. Results:
The final results of this trial were presented at ASCO 2022 where it was concluded as follows:
“CONTROL NETs is the first randomized trial to demonstrate efficacy for PRRT in pNETs, in addition to a standard of care. Extended follow up confirms durable CAPTEM/PRRT activity, with superior PFS in pNETs. Late haematologic toxicity was seen in both mNET PRRT arms but was not higher with additional CAPTEM. The activity of CAPTEM/PRRT in pNETs should be tested in the phase III setting” – click here to read the abstract.
Combination treatments are common in chemotherapy, but this trial was different as it effectively combined the use of different therapies both with their own toxicity risks, albeit low in each therapy type.
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Ronny
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