Fig. 2—

Schematic shows potential time points for peptide receptor radionuclide therapy (PRRT) therapy in management of neuroendocrine neoplasms (NENs) according to European Society for Medical Oncology clinical practice guidelines [25]. PRRT can be considered after initial medical management in patients with somatostatin receptor (SSTR)-positive small-bowel and pancreatic NENs. Specifically, PRRT can be considered for grade 2 (G2) small-bowel NENs after progression with serotonin analogue (SSA) therapy and is considered equivalent alternative to everolimus. PRRT can be considered for grade 1 (G1) and potentially grade 2 pancreatic NENs if progression occurs with SSA therapy and is considered equivalent to other available agents. FOLFOX = leucovorin calcium (folinic acid), fluorouracil, and oxaliplatin, FOLFIRI = leucovorin calcium (folinic acid), fluorouracil, and irinotecan hydrochloride, CAPTEM = capecitabine and temozolomide, STZ = streptozotocin, 5-FU = 5-fluorouracil, Ki67 = nuclear protein Ki67.