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ComPareNET: Lu-177 DOTATATE vs CAPTEM in Advanced pNETs << Back Comparing Capecitabine and Temozolomide in Combination to Lutetium Lu-177 Dotatate in Patients with Advanced Pancreatic Neuroendocrine Tumors CLINICALTRIALS.GOV IDENTIFIER: NCT05247905 DRUG/TREATMENT: Lutetium Lu-177 Dotatate PRRT (Peptide Receptor Radionuclide Therapy) versus CAPTEM (Capecitabine and Temozolomide) PHASE: 2 STATUS: Closed SPONSOR: Alliance for Clinical Trials in Oncology, National Cancer Institute (NCI) https://www.youtube.com/watch?v=jEO6in8giTk Dr. Heloisa Soares Discusses ComPareNET: Lu-177 DOTATATE vs CAPTEM DESCRIPTION: This phase II trial compares capecitabine and temozolomide to lutetium Lu-177 dotatate for the treatment of pancreatic neuroendocrine tumors that have spread to other parts of the body (advanced) or are not able to be removed by surgery (unresectable). Chemotherapy drugs, such as capecitabine and temozolomide, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Radioactive drugs, such as lutetium Lu-177 dotatate, may carry radiation directly to tumor cells and may reduce harm to normal cells. The purpose of this study is to find out whether capecitabine and temozolomide or lutetium Lu-177 dotatate may kill more tumor cells in patients with advanced pancreatic neuroendocrine tumors. For more information on eligibility criteria, trial locations, study details, etc., go to ClinicalTrials.gov to view this trial here. CONTACT: This is a multicenter trial with various locations. Go to the “Contacts and Locations” section of this trial page at ClinicalTrials.gov for site-specific contact information.

<< Go Back to NCF Events Page “ Luncheon With The Experts ” is a recurring educational outreach series (previously hosted by the Carcinoid Cancer Foundation) aimed at patients, caregivers, and the broader neuroendocrine cancer community. The sessions are hosted by Rain Bennett. The series features medical specialists — oncologists, surgeons, researchers, and other clinical experts — who present on topics relevant to neuroendocrine cancer and answer audience questions live via chat. Programs are typically delivered live (over Facebook Live and YouTube Live ) at noon Eastern Time, allowing participants to join with their lunch break. Live sessions are recorded and will be available afterwards. ABOUT BORIS G. NARAEV, MD, PHD, FACP Dr. Naraev is a board-certified medical oncologist at the Tampa General Hospital’s Cancer Institute specializing in caring for people living with neuroendocrine and endocrine tumors. He is an Associate Professor of Medicine at the Division of Hematology and Medical Oncology of University of South Florida, Morsani College of Medicine. Prior to joining the TGH Cancer Institute, he was the Lead of Neuroendocrine Cancer Program at Banner MD Anderson Cancer Center in Phoenix, Arizona and Adjunct Assistant Professor with the Department of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, Texas. While in Phoenix, he helped create, develop, and lead one of the largest neuroendocrine cancer programs in the Southwestern United States, and was personally taking care of a large population of patients with neuroendocrine tumors. Later, he served as the Leader of Gastrointestinal, Neuroendocrine, and Rare Cancers Program at the Anderson Family Cancer Institute at Jupiter Medical Center in Jupiter, Florida. In this capacity, he helped build the National Pancreas Foundation Pancreatic Cancer Center of Excellence at Jupiter Medical Center. He received his Doctor of Medicine degree from Orenburg State Medical Academy in Orenburg, Russia. Subsequently, he obtained a PhD in Medical Sciences degree from the same institution. After completion of Internal Medicine residency training at St. Luke's Hospital in Chesterfield, Missouri, he proceeded to complete Hematology/Oncology Fellowship at the University of Iowa Hospitals and Clinics in Iowa City, Iowa. During his fellowship training, he developed a special interest in neuroendocrine tumors and completed several research projects in this field. Dr. Naraev is involved in neuroendocrine tumors related research and community outreach, and is a member of the NETPact Committee and Chair of the Guidelines Committee of the North American Neuroendocrine Tumor Society (NANETS). Dr. Naraev also serves as a member of the National Cancer Institute’s Neuroendocrine Tumors Task Force. HOST The sessions are hosted by Rain Bennett , a two-time Emmy-nominated filmmaker, author, and experienced host who produces and leads live conversations on behalf of the Neuroendocrine Cancer Foundation. Bennett has been involved with the neuroendocrine cancer community as a longtime filmmaker and supporter, using his storytelling and interview skills to bring expert perspectives to patients and caregivers. THANKS TO OUR SPONSORS The opinions expressed by the guest presenters, as well as the questions asked by the audience, have not been created or suggested by NCF or the sponsors of this program. NCF does not endorse or promote any of the views, opinions or information provided in this presentation. Audience members should not rely solely on the opinions or information expressed by the guest presenter and should seek guidance and direction from their own medical advisors regarding any choices they make about their health or treatments. << Go Back to NCF Events Page

BRAVESST2: CRN09682 in SST2-Expressing NENs and Other Solid Tumors << Back BRAVESST2: A Study to Investigate Safety and Effectiveness of CRN09682 in Participants With SST2-Expressing NENs and Other Solid Tumors IDENTIFIER ( ClinicalTrials.gov ) : NCT07129252 DRUG/TREATMENT : CRN09682 PHASE : 1/2 STATUS : Recruiting SPONSOR : Crinetics Pharmaceuticals, Inc. Download the BRAVESST2 Study Brochure here >>> DESCRIPTION: BRAVESST-2 is a Phase 1/2, first-in-human clinical trial studying a new investigational medication called CRN09682. This treatment is designed for people with metastatic or locally advanced neuroendocrine tumors (NETs), neuroendocrine carcinomas (NECs), or other solid tumors that express somatostatin receptor type-2 (SST2). What is CRN09682? CRN09682 is a potential new antibody-drug conjugate (ADC) that is given by intravenous (IV) infusion. It is designed to: Recognize and attach to SST2-positive cancer cells, and Deliver a cancer-fighting drug (MMAE) directly to those cells The goal is to slow or stop tumor growth while limiting exposure to healthy cells. Why This Study Matters This study aims to understand: Safety — what side effects occur and at what doses Tolerability — how participants handle the medication How the drug behaves in the body Early signs of effectiveness in SST2-expressing tumors Because this is a first-in-human study, CRN09682 has not yet been approved by any regulatory authority. Who Can Join You may be eligible if you: Are 18 years or older Have progressive, metastatic, or locally advanced NET, NEC, or another SST2-positive solid tumor Examples include: pancreatic, lung, or GI NETs; small or large cell lung cancer; extra-pulmonary NEC; colorectal, gastric, breast, hepatocellular, nasopharyngeal carcinomas; Merkel cell carcinoma; and melanoma Crinetics_BRAVESST2_Bi-fold Par… Have not had surgery in the last 90 days Have not received prior treatment with MMAE-based therapies Your study team will confirm your full eligibility. What Participation Involves Screening period: up to 28 days IV treatment every 21 days (Cycle 1, then additional cycles) Safety follow-up: 30 days after the last dose Long-term follow-up: every 3 months Optional tumor biopsies What to Expect The study drug, lab tests, imaging, and all study procedures are provided at no cost Travel expenses may be reimbursed You may stop participation at any time For more information on eligibility criteria, trial locations, study details, etc., go to ClinicalTrials.gov to view this trial here. CONTACT Name: Crinetics Clinical Trials Phone Number: 833-276-4636 Email: clinicaltrials@crinetics.com This is a multicenter trial with various locations. Go to the “Contacts and Locations” section of this trial page at ClinicalTrials.gov for site-specific contact information.

CAREFNDR: Carcinoid Syndrome Efficacy Study Featuring an Oral Daily Paltusotine Regimen << Back CAREFNDR: Carcinoid Syndrome Efficacy Study Featuring an Oral Daily Paltusotine Regimen IDENTIFIER ( ClinicalTrials.gov ) : NCT07087054 DRUG/TREATMENT : Paltusotine PHASE : 3 STATUS : Recruiting SPONSOR : Crinetics Pharmaceuticals Inc. https://www.youtube.com/watch?v=b6Jnzj9Epng CAREFNDR Presentation Slides .pdf Download PDF • 1.60MB DESCRIPTION: A Phase 3, randomized, double-blinded, placebo-controlled study to evaluate the efficacy and safety of paltusotine treatment vs placebo as well as the long-term safety of paltusotine in adults with carcinoid syndrome due to well-differentiated neuroendocrine tumors. The purpose of this study is to continue the evaluation of the safety, efficacy, and pharmacokinetics (PK) of paltusotine in participants with carcinoid syndrome. For more information on eligibility criteria, trial locations, study details, etc., go to ClinicalTrials.gov to view this trial here. MORE INFORMATION Download the CAREFNDR flyer here >>> For more information about the CAREFNDR clinical study, visit CAREFNDR.com/ncf . Global enrollment in CAREFNDR is expected throughout 2025 and 2026. Read this recent press release: " Crinetics Announces First Patient Randomized in Pivotal Phase 3 CAREFNDR Trial Evaluating Paltusotine in Carcinoid Syndrome" CONTACT Crinetics Clinical Trials EMAIL: clinicaltrials@crinetics.com PHONE: 833-276-4636 This is a multicenter trial with various locations. Go to the “Contacts and Locations” section of this trial page at ClinicalTrials.gov for site-specific contact information.

<< Go back to the Podcast page EPISODE 22: WHAT TO KNOW ABOUT PANCREATIC NETS Download a Transcript of this Episode >> ABOUT THIS EPISODE What is the difference between Pancreatic Neuroendocrine Tumor (PNET) and Pancreatic Cancer? Where exactly is the pancreas located and why is the tumor location important? NET Oncologist Dr. Jennifer Chan from Dana-Farber Cancer Institute takes us through how some treatments, imaging and blood work are unique to PNETs. She also expounds on several ongoing and active trials. MEET DR. JENNIFER CHAN Jennifer Chan, MD, MPH is an Associate Professor of Medicine at Harvard Medical School and Institute Physician in the Division of Medical Oncology at Dana-Farber Cancer Institute in Boston, MA. She focuses her clinical practice on the care of patients with neuroendocrine tumors and gastrointestinal cancers. Dr. Chan is the Director of the Program in Neuroendocrine and Carcinoid Tumors and Clinical Director for the Gastrointestinal Cancer Center at the Dana-Farber/Brigham and Women's Cancer Center. She has been principal investigator of multiple clinical trials investigating novel therapies for neuroendocrine tumors and has been involved in studies examining factors associated with clinical outcomes in patients with neuroendocrine tumors. Dr. Chan is a past chair of the Guidelines Committee of the North American Neuroendocrine Tumor Society (NANETS) and serves on the National Comprehensive Cancer Network (NCCN) Neuroendocrine Tumors Guidelines Panel. She is a member of the Neuroendocrine Tumor Taskforce of the National Cancer Institute and the Board of Directors of NANETS. TOP 10 QUESTIONS 1. What are pancreatic NETs? Where are they located? 2. How are pancreatic NETs found? What are the symptoms of a pancreatic NET? 3. How is pancreatic NETs different from “pancreatic cancer?” How is it different from a pancreatic cyst? 4. What types of labs, scans, or testing is done to determine if someone has a pancreatic NET? 5. What are some ways that pancreatic NETs differ from other types of NETs? What makes it unique? 6. How do you decide if the pancreatic NET can be surgically removed? What type of surgeon would make that determination? 7. How are pancreatic NETs treated medically (or nonsurgically)? How are treatments sequenced? 8. How are the treatments different from other NETs? 9. How are pancreatic NETs monitored? What types of bloodwork or tests should be done and how often should they be done? What is the best type of scan for pancreatic NETs? 10. What are clinical trials we should be aware of or exciting new treatments in the pipeline for pancreatic NETs? RESOURCES https://www.youtube.com/watch?v=2H_SChk3gxw "CABINET Trial - Cabozantinib in Advanced Pancreatic Neuroendocrine and Carcinoid Tumors Video Introduction" - Jennifer Chan https://www.youtube.com/watch?v=HHtDAQzDj9E "Update on NET Clinical Trials" with Dr. Heloisa Soares (Recorded March 10, 2023) https://www.youtube.com/watch?v=ozTjElpHiyQ "NET Medical Therapies & Clinical Trials" with Dr. Reidy-Lagunes - LACNETS 2022 LACNETS Annual Conference (Recorded June 18, 2022 ) https://www.youtube.com/watch?v=sZIVip3CIxI Systemic Therapy: GI, Lung, PNETS & Unknown Primary" - LACNETS 2020 Virtual NET Conference ( Recorded June 20, 2020 ) https://www.youtube.com/watch?v=u9-iTXz8G2Y NET Patient Mary's Story https://www.youtube.com/watch?v=ncemqQ_vhMI NET Patient Tom's Story https://www.youtube.com/watch?v=Mm7tQpqoxBU NET Caregiver Gilda's Story https://www.youtube.com/watch?v=aZtVzVO-JO0 NET Patient Federico's Story LISTEN LACNETS Podcast Episode 5: "Treatment for NETs" with Dr. Randy Hecht LACNETS Podcast Episode 7: "Imaging of NETs" with Dr. Gary Ulaner LACNETS Podcast Episode 11: "Pathology for NETs" with Dr. Sue Chang LACNETS Podcast Episode 19: "Beyond the Basics: The Pathology of NET" with Dr. Andrew M. Bellizzi NETWise Podcast Episode 10: Pancreatic NETs + Take the Quiz READ 2020 The North American Neuroendocrine Tumor Society Consensus Guidelines for Surveillance and Medical Management of Pancreatic Neuroendocrine Tumors 2020 The North American Neuroendocrine Tumor Society Consensus Paper on the Surgical Management of Pancreatic Neuroendocrine Tumors CABINET Trial - Cabozantinib in Advanced Pancreatic Neuroendocrine and Carcinoid Tumors DISCLAIMER LACNETS Podcasts are created for educational purposes only and do not substitute for medical advice. The views shared in this Podcast are the personal opinions of the experts and do not necessarily reflect the views of LACNETS. Please contact your medical team with questions or concerns about your individual care or treatment. THANK YOU TO OUR SPONSORS

<< Go back to the Podcast page EPISODE 40: NEN TREATMENTS: FOCUS ON EXTERNAL RADIATION THERAPY Download a Transcript of this Episode >>> ABOUT THIS EPISODE What is radiation oncology, and how is it used for neuroendocrine cancer? UCSF radiation oncologists Dr. Will Chen and Dr. Alexandra Hotca-Cho describe external radiation therapy (SBRT) and how, when, and where it may be used for select patients with neuroendocrine cancers. They address common concerns about the planning process, safety concerns, and treatment sequencing. MEET DR. WILLIAM C. CHEN Dr. William C. Chen is a radiation oncologist and translational researcher. Dr. Chen received his undergraduate degree from Johns Hopkins University and completed medical school at the University of California, San Francisco. He completed his internal medicine preliminary internship at Kaiser San Francisco, followed by a residency in Radiation Oncology at UCSF. He is a Chan Zuckerburg Biohub Physician Scientist Fellow and a Helen Diller Family Cancer Center Physician Scientist Program in Clinical Oncology (PSPCO) Fellow. His research focuses on biomarker development, informatics, and clinical trial development with a focus on meningiomas and other malignancies of the central nervous system and beyond. MEET DR. ALEXANDRA HOTCA-CHO Dr. Hotca specializes in treating gastrointestinal cancers, with expertise in advanced radiation therapy techniques such as intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), stereotactic body radiation therapy (SBRT), and respiratory gating. These approaches are designed to optimize treatment outcomes and minimize side effects. Her research focuses on enhancing patient quality of life through preventive strategies and identifying predictive biomarkers for radiation-induced toxicities. Dr. Hotca is dedicated to providing exceptional care to the diverse patient community at UCSF. TOP TEN QUESTIONS ABOUT EXTERNAL RADIATION THERAPY: 1. What is radiation oncology? How does it work? How is it different from other types of radiation? 2. What are the types of radiation therapies used for neuroendocrine cancer? 3. Which neuroendocrine cancers are they used for, and when are they used? How do you decide who is a good candidate and if it will be effective? Where in the body can SBRT be used? (bone, liver, pancreas, rectal?) Where can it not be used in the body, and when is SBRT NOT used? Is there a number or size limit of the tumor(s)? 4. For Bone: How do NETs affect the bones? Are they “on” or “in” the bone, and does the tumor tend to weaken it? If given to the bone, does SBRT weaken the bone? What are the chances of fracture with radiation to the bone? Does it matter which area of the bone/body is treated? What other factors influence fracture risk? (age, dose, number of treatments)? Should patients have a bone density scan before SBRT? If bone lesions are causing pain, how soon after treatment might a patient expect to have pain alleviated? How common is increased pain after treatment to the bone? What causes that? 5. Safety: How much radiation is given with these procedures? Is there a concern about radiation safety following the procedures? (Do patients need to avoid others in the hours or days after the treatment?) Is there a lifetime limit to the amount of radiation one can receive, especially considering surveillance CT & PET scans? How often can these procedures be repeated? Does it damage other tissues or organs? How common are secondary cancers? What types and how treatable are they? Is there a risk with fertility? What other risks are there? 6. How do these therapies compare to PRRT or radioembolization in terms of safety? If someone has had PRRT or radioembolization, can they also receive radiation therapy to the liver or bones? Is there increased risks if someone has had PRRT, radioembolization or CAPTEM or alkylating agents? 7. Is there an optimal sequence for treatments? 8. What is SBRT like for patients? What is the planning and preparation process? How do you determine how many treatments and what dose to give? 9. What does the patient experience during and after the procedure? Does it hurt? What are the side effects? How much time do I need to take off of work? 10. How effective is SBRT in terms of managing symptoms? How effective is SBRT in controlling or destroying the tumor? How do you know if the treatment “worked”? Bonus: What is the future of radiation therapy in neuroendocrine cancer treatment? RESOURCES READ Stereotactic Ablative Radiotherapy for the Management of Liver Metastases from Neuroendocrine Neoplasms: A Preliminary Study DISCLAIMER LACNETS Podcasts are created for educational purposes only and do not substitute for medical advice. The views shared in this Podcast are the personal opinions of the experts and do not necessarily reflect the views of LACNETS. Please contact your medical team with questions or concerns about your individual care or treatment. THANK YOU TO OUR SPONSORS

IDE849 (DLL3-targeted ADC) ± Durvalumab in DLL3+ Tumors << Back A Study of IDE849 in Patients with DLL3 Expressing Tumors Including Small Cell Lung Cancer IDENTIFIER ( ClinicalTrials.gov ) : NCT07174583 DRUG/TREATMENT : IDE849, an anti-DLL3 antibody-drug conjugate PHASE : 1/2 STATUS : Recruiting SPONSOR : IDEAYA Biosciences DESCRIPTION: This is a Phase 1/2, multi-center clinical trial studying a new treatment called IDE849 in people with DLL3-expressing cancers, including small cell lung cancer (SCLC), high-grade neuroendocrine carcinomas (NECs), and other solid tumors. What is DLL3? DLL3 (delta-like ligand 3) is a protein found on the surface of some cancer cells, especially high-grade neuroendocrine cancers. Because DLL3 is much less common on normal cells, it has become an important target for new cancer treatments. What is IDE849? IDE849 is an antibody-drug conjugate (ADC), a newer type of targeted cancer therapy. ADCs combine: an antibody, which acts like a homing device to find cancer cells with a specific marker (like DLL3), and a drug payload (often a chemotherapy-like agent) that is delivered directly to those cells IDE849 is designed to find DLL3-positive cancer cells and deliver a cancer-fighting drug directly to them, which may help kill cancer cells while limiting damage to healthy tissue. In this study, IDE849 is being tested: on its own, and in combination with other treatments, including durvalumab (an immunotherapy) or another investigational drug (IDE161) About the Study Researchers want to understand: Safety and side effects How well the treatment works How the drug moves through and affects the body (pharmacokinetics and immunogenicity) The best dose to use in future studies How the Study is Structured Part 1 (Dose Escalation): Participants receive increasing doses of IDE849 (alone or in combination) The goal is to find the safest and most effective dose Part 2 (Dose Expansion): Participants receive the selected dose(s) Researchers further evaluate safety and early effectiveness in specific groups of patients Who This Study Is For This study is enrolling people with: Small cell lung cancer (SCLC) High-grade neuroendocrine carcinomas (NECs) Other solid tumors that express DLL3 Why This Matters Treatment options for high-grade neuroendocrine carcinomas (NECs) and small cell lung cancer (SCLC) are often limited, especially after standard therapies stop working. DLL3-targeted therapies like IDE849 represent a promising new approach because they are designed to specifically target cancer cells that carry the DLL3 marker. By delivering treatment directly to these cells, this strategy may improve effectiveness while limiting damage to healthy tissue. This study is also exploring combination approaches, including immunotherapy, which may further enhance how well treatment works. If successful, this research could help expand treatment options for patients with DLL3-positive cancers, including those beyond small cell lung cancer. CONTACT For more information on eligibility criteria, trial locations, study details, etc., go to ClinicalTrials.gov to view this trial here. Name: IDEAYA Clinical Trials Phone Number: +1-855-433-2246 Email: IDEAYAClinicalTrials@ideayabio.com This is a multicenter trial with various locations. Go to the “Contacts and Locations” section of this trial page at ClinicalTrials.gov for site-specific contact information.

Lu-177 DOTATATE vs Everolimus in Lung NETs << Back Randomized Phase II Trial of Lutetium Lu-177 Dotatate Versus Everolimus in Somatostatin Receptor Positive Bronchial Neuroendocrine Tumors DRUG/TREATMENT: LUTETIUM LU-177 DOTATATE (PRRT) + (EVEROLIMUS) CLINICALTRIALS.GOV IDENTIFIER: NCT04665739 PHASE: 2 STATUS: Recruiting SPONSOR: National Cancer Institute (NCI) https://www.youtube.com/watch?v=v8Ev1_8DVdo Dr. Suki Padda Discusses Lu177 Dotatate in Lung NETs https://www.youtube.com/watch?v=Z6ky87smo-I Dr. Heloisa Soares Discusses Lu-177 Dotatate in Lung NETs DESCRIPTION: This phase II trial studies the effect of lutetium Lu-177 dotatate compared to the usual treatment (everolimus) in treating patients with somatostatin receptor positive bronchial neuroendocrine tumors that have spread to other places in the body (advanced). Radioactive drugs, such as lutetium Lu-177 dotatate, may carry radiation directly to tumor cells and may reduce harm to normal cells. Lutetium Lu-177 dotatate may be more effective than everolimus in shrinking or stabilizing advanced bronchial neuroendocrine tumors. For more information on eligibility criteria, trial locations, study details, etc. go to ClinicalTrials.gov to view this trial here. PRINCIPAL INVESTIGATORS: Thomas A. Hope, MD, UCSF Sukhmani K. Padda, MD, Cedars Sinai Medical Center, Los Angeles, California CONTACT: This is a multicenter trial with various locations. Go to the “Contacts and Locations” section of this trial page at ClinicalTrials.gov for site-specific contact information.

<< Go back to the Podcast page EPISODE 30: BONE & BRAIN METASTASES IN NEUROENDOCRINE CANCER Download a Transcript of this Episode >> ABOUT THIS EPISODE When and how often do NETs spread to the bones or brain? How are they found? What is the treatment? Dr. Robert Ramirez of Vanderbilt University addresses concerns surrounding bone metastases (or “mets”) as well as rare brain metastases. MEET DR. ROBERT RAMIREZ, DO, FACP Dr. Robert Ramirez is a medical oncologist specializing in the treatment of thoracic and neuroendocrine malignancies and an Associate Professor of Medicine at Vanderbilt University Medical Center in Nashville, TN. He earned his medical degree from the University of Medicine and Dentistry of New Jersey School of Osteopathic Medicine. He completed an internal medicine residency at Cooper University Hospital in Camden, New Jersey. He then completed a hematology and medical oncology fellowship at the University of Tennessee Health Sciences Center in Memphis, Tennessee and served as chief fellow. He is a Fellow of the American College of Physicians, and a member of American Society of Clinical Oncology, the International Association for the Study of Lung Cancer (IASLC), and the North American Neuroendocrine Tumor Society (NANETS). He serves on the Board of Directors for NANETS as well as the Scientific Review and Research Committee. His clinical and research interests include neuroendocrine tumors (NETs) and lung cancer. He has a specific interest in NETs of the lung ranging from diffuse idiopathic pulmonary neuroendocrine tumor cell hyperplasia (DIPNECH) and carcinoid tumors to small cell lung cancer and other high-grade neuroendocrine carcinomas. He is active in clinical trial design including investigator-initiated trials. He enjoys teaching residents and fellows and has multiple publications and given many lectures for the scientific community on the topics of NETs and lung cancers. TOP TEN QUESTIONS Bone mets: 1. When and how often do NETs spread to the bones? 2. Where in the bones are tumors? What does it mean when NETs spread to the bones? How does this compare to other cancers? 3. How are bone spots found and monitored? Should they be biopsied? 4. What is the treatment for bone mets? Should I have radiation? Would radiation limit my ability to get PRRT? 5. Should I be on bone strengthening medication? Am I at higher risk for fractures (or breaking my bones) if I have NETs in the bones? 6. Do bone mets respond to PRRT? 7. Does having bone mets put me at a higher risk of MDS? Brain mets: 8. When and how often do NETs spread to the brain? Do all types of NETs have the potential to spread to the brain? 9. How are brain mets found and monitored? When should I suspect this? 10. How are brain mets treated? What does having brain mets mean for my life? *Bonus: What final words of hope do you have for the neuroendocrine cancer community? RESOURCES WATCH https://www.youtube.com/watch?v=eC5OGO6VvEE LISTEN LACNETS Lung NET Resources DISCLAIMER LACNETS Podcasts are created for educational purposes only and do not substitute for medical advice. The views shared in this Podcast are the personal opinions of the experts and do not necessarily reflect the views of LACNETS. Please contact your medical team with questions or concerns about your individual care or treatment. THANK YOU TO OUR SPONSORS

<< Back Surgery Trials SWOG S2104: Adjuvant CAPTEM for High Risk pNET SWOG 2408: Lanreotide vs Placebo Before Surgery to Prevent Pancreatic Fistula

COMPOSE: PRRT with Lu-177 EDOTREOTIDE versus “Standard of Care” in Well-Differentiated Aggressive G2 & G3 GEP-NETs << Back ITM (COMPOSE) Phase III Clinical Trial: 177 LU-EDOTREOTIDE VS. Best Standard of Care in Well-Differentiated Aggressive G2 & G3 GEP-NETs CLINICALTRIALS.GOV IDENTIFIER: NCT04919226 DRUG/TREATMENT: 177Lu-Edotreotide PRRT (Peptide Receptor Radionuclide Therapy) PRRT versus CAPTEM (Capecitabine and Temozolomide), Everolimus or FOLFOX (Folinic acid + Fluorouracil + Oxaliplatin) PHASE: 3 STATUS: Recruiting SPONSOR: ITM https://www.youtube.com/watch?v=r1hmEzrooxE Dr. Heloisa Soares Discusses COMPOSE: PRRT -LU-177 EDOTREOTIDE https://www.youtube.com/watch?v=w9kA8_gmVfM Dr. Will Pegna Discusses COMPOSE: PRRT - LU-177 EDOTREOTIDE Starting at 9:04 UPDATE (March 2025) https://www.youtube.com/watch?v=H0H1RNwIwV0 The Neuroendocrine Cancer Foundation @NCFCancer (previously @LACNETS) interviews Mayo Clinic Medical Oncologist and #NetCancer expert Dr. Thor Halfdanarson at the 2025 ENETS Annual Medical and Scientific Conference in Krakow, Poland (March 5-7, 2025). Dr. Halfdanarson shares the breaking news of positive results from ITM’s phase 3 COMPETE trial, the first prospective, randomized phase 3 study comparing PRRT with an active treatment (everolimus). DESCRIPTION: ITM is sponsoring “COMPOSE,” an international phase III clinical study to evaluate the efficacy, safety and impact on quality of life of Targeted Radionuclide Therapy (PRRT) with no-carrier-added lutetium-177-edotreotide (n.c.a. 177Lu-edotreotide) compared to a standard therapy with either CAPTEM or everolimus or FOLFOX, in patients with well-differentiated advanced Grade 2 and Grade 3, somatostatin receptor-positive (SSTR+) neuroendocrine tumors of gastroenteric or pancreatic origin (G2 and G3 GEP-NETs). The study is being conducted predominantly in Europe, North America, India and Australia, in approximately 10 countries and 40 sites. For more information on eligibility criteria, trial locations, study details, etc., go to ClinicalTrials.gov to view this trial here. CONTACT: Dr. Nicolas Schneider or Amanda Rotger at ITM EMAIL: info-solucin@itm-radiopharma.com

<< Go back to the Podcast page EPISODE 44: UNDERSTANDING CLINICAL TRIALS & HOW THEY FIT IN THE NEUROENDOCRINE CANCER JOURNEY Download a Transcript of this Episode >>> ABOUT THIS EPISODE When in one’s neuroendocrine cancer journey might a clinical trial be considered? What factors influence treatment decisions, including whether to pursue a clinical trial? Dr. Alexandria Phan, medical oncologist at the Medical College of Wisconsin, offers thoughtful guidance on when and how clinical trials fit into the neuroendocrine cancer journey. This episode helps demystify the clinical trial process and empowers patients to engage in meaningful, proactive conversations with their care teams. MEET ALEXANDRIA PHAN, MD, FACP Dr. Alexandria Phan is a hematologist and medical oncologist at the Froedtert & Medical College of Wisconsin. Clinical practice, clinical research and education are three pillars important to Dr. Phan’s approach to cancer care. Her areas of focus for clinical research and patient care are neuroendocrine tumors and malignancies of the gastrointestinal system. She has held several leadership positions including cancer center director, founding program director for Hematology-Oncology fellowship, medical director of clinical research, and national director for GI cancer program. TOP TEN QUESTIONS: What is a clinical trial? When in one’s neuroendocrine cancer journey might a clinical trial be considered? Many people think of clinical trials as a “last resort” option? When in one’s neuroendocrine cancer journey should a clinical trial be considered? How do you, as a neuroendocrine expert, consider clinical trials for your patients? What is the process of considering clinical trials? Do you suggest them or do your patients suggest them? If a patient is interested, do you refer them to a clinical trial or is it their responsibility to reach out to the investigator (if it is not you)? If I am at a decision point and there are multiple treatment options available including clinical trials, what advice or insights do you have to help make this decision? When might a clinical trial be “better” than what is already available? How does timing factor into the decision? How long does it take to enroll/start a clinical trial? What if the trial is not available at the institution I’m going to? How do patients keep abreast of clinical trials? How can they better understand the trial? How long do clinical trials take? If I start a clinical trial, how long could I expect to be on it? How often do clinical trials open/close? How often do spots [slots] open? How do I optimize my options? If I want to keep my options open for future clinical trials, what are certain considerations in selecting current treatments to make sure to maximize future clinical trials options? What is on the horizon for neuroendocrine cancer that you’re most optimistic about? RESOURCES Clinical Trials Guide View more videos on research and clinical trials in our Video Library>>> READ CHD Guidelines & Articles: ENETS guidance paper for carcinoid syndrome and carcinoid heart disease Davar et al (2017) Diagnosing and Managing Carcinoid Heart Disease in Patients With Neuroendocrine Tumors: An Expert Statement. J Am Coll Cardiol.; 69 (10) 1288–1304 Jin et al (2021) Carcinoid Heart Disease: Pathophysiology, Pathology, Clinical Manifestations, and Management. Cardiology;146:65–73 Ram et al (2019) Carcinoid Heart Disease:Review of Current Knowledge. Texas Heart Institute Journal February 2019, Vol. 46, No. 1 Additional Resources: Xermelo or Telotristat Ethyl Interscience Institute provides NET Diagnostic Testing including pancreastatin and serotonin. DISCLAIMER The Neuroendocrine Cancer Foundation Podcasts are created for educational purposes only and do not substitute for medical advice. The views shared in this Podcast are the personal opinions of the experts and do not necessarily reflect the views of the Neuroendocrine Cancer Foundation. Please contact your medical team with questions or concerns about your individual care or treatment. THANK YOU TO OUR SPONSORS