177Lu-DOTATOC for the Treatment of Patients With Somatostatin Receptor Positive NETs

Inclusion Criteria: * Able to provide written informed consent * Age greater than or equal to 19 years * Biopsy-proven, well-differentiated grade 1 - 3 NET * Gastroenteropancreatic tumors (e.g. carcinoids, gastrinoma, insulinoma, glucagonoma, VIPoma, etc.), functioning and non-functioning * Sympathoadrenal system tumors (phaeochromocytoma, paraganglioma) * Pulmonary NET, functioning and non-functioning * Easter Cooperative Oncology Group (ECOG) ≤ 2 * Ki67 ≤ 55% * Progressive disease demonstrated by RECIST 1.1 criteria within the 6 months preceding the study. * Patients with other evidence of progressive disease that is not demonstrated on CT (like rising biomarkers) may be included, at the discretion of the Tumour Review Board. * If response to other treatments is considered adequate according to other criteria, the Tumour Review Board may consider excluding the patient from participation in the study. * Tumour Review Board confirmation of suitability to proceed to PRRT treatment and enrollment in this trial. * Positive PET SSR imaging (Krenning score 2 or higher) in previous 6 months (68Ga-DOTATOC, 68Ga-DOTATATE, 18F-AmBF3-TATE). If PET SSR imaging is not available 111In-penetreotide scintigraphy (Octreotide scan) is acceptable. * Adequate laboratory parameters within two weeks of enrollment * Kidneys * Serum creatinine ≤ 150 µmol/L * GFR ≥ 40 ml/min (using plasma clearance values) * Marrow * Hemoglobin ≥ 80 g/L * WBC ≥ 2 x 109/L * Platelets ≥ 75 x 109/L * Liv…