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Experts Struggle to Agree on How to Measure Whether PRRT Cancer Treatment Is Working

Consensus StatementModerate evidence
The takeaway

ENETS expert survey reveals major gaps and disagreements in how to assess response to peptide receptor radionuclide therapy for neuroendocrine tumors.

70% response

ENETS Advisory Board survey on PRRT response assessment practices and unmet needs

What the researchers found

Expert survey revealed significant variability and unmet needs in PRRT response assessment, with no consensus on standardized criteria.

Why it matters

Without standardized response criteria, clinicians cannot reliably compare PRRT outcomes across centers or decide when to stop or modify treatment.

The numbers in context

70% of Advisory Board responded; 81% from ENETS Centers of Excellence; 13 questions; 46% achieved >75% agreement; 39% achieved >60% agreement.

How the study worked

Statement-based survey of ENETS Advisory Board members (70% response rate) with 13 questions and substatements.

Who was studied

ENETS Advisory Board members (neuroendocrine tumor specialists)

What this study cannot tell us

Expert survey — reflects opinions rather than evidence. Response criteria have not yet been validated prospectively.

How to read the evidence

Expert consensus survey — captures current practice variability but does not provide validated criteria.

When this study was published

Published in 2025 from the 2022 ENETS meeting, reflecting ongoing efforts to standardize PRRT assessment.

The bigger picture

Standardizing PRRT response assessment would improve clinical trials, enable better comparisons, and ultimately improve patient care.

Questions still open

  • Should functional imaging replace morphological criteria for PRRT response?
  • Can molecular markers complement imaging for earlier response assessment?

Common questions

How do doctors know if PRRT is working?
This is actually a major challenge — tumors may not shrink immediately after PRRT, and current measurement criteria were designed for other treatments.
Why are standardized criteria important?
Without agreed-upon measures, different hospitals may reach different conclusions about whether treatment is working, affecting patient care decisions.

Read the original research

Challenges in developing response evaluation criteria for peptide receptor radionuclide therapy: A consensus report from the European Neuroendocrine Tumor Society Advisory Board Meeting 2022 and the ENETS Theranostics Task Force.

Journal of neuroendocrinology, 37(2), e13479

Citation

Prasad, Vikas; Koumarianou, Anna; Denecke, Timm; Sundin, Anders; Deroose, Christophe M; Pavel, Marianne; Christ, Emanuel; Lamarca, Angela; Caplin, Martyn; Castaño, Justo P; Dromain, Clarisse; Falconi, Massimo; Grozinsky-Glasberg, Simona; Hofland, Johannes; Knigge, Ulrich Peter; Kos-Kudla, Beata; Krishna, Balkundi A; Reed, Nicholas Simon; Scarpa, Aldo; Srirajaskanthan, Rajaventhan; Toumpanakis, Christos; Kjaer, Andreas; Hicks, Rodney J; Ambrosini, Valentina. (2025). Challenges in developing response evaluation criteria for peptide receptor radionuclide therapy: A consensus report from the European Neuroendocrine Tumor Society Advisory Board Meeting 2022 and the ENETS Theranostics Task Force.. Journal of neuroendocrinology, 37(2), e13479. https://doi.org/10.1111/jne.13479