177Lu-Dotatate for Midgut Neuroendocrine Tumors

_To the Editor:_ Although the results of the multicenter, randomized, controlled Neuroendocrine Tumors Therapy (NETTER-1) trial reported by Strosberg et al. (Jan. 12 issue) validate the experience gained over the past decade by many institutions, we think that they overstate the toxic effects of lutetium-177 (177Lu)–Dotatate and potentially underestimate its efficacy relative to other potential therapies for these tumors. [...]