Zhang J, et al. - In patients with somatostatin receptor (SSTR)–expressing grade 3 (G3) neuroendocrine neoplasms (NENs), researchers analyzed the long-term outcome, effectiveness and safety of peptide receptor radionuclide therapy (PRRT). In total, 69 subjects (41 men; age, 28–81 y) received PRRT with ¹⁷⁷Lu- or ⁹⁰Y-labeled somatostatin analogs (DOTATATE or DOTATOC). Twenty-two subjects underwent radiosensitizing chemotherapy. Findings suggested that PRRT has been well tolerated without significant adverse effects and has been effective in G3 NENs. The clinical outcome was promising, particularly in patients with a Ki-67 index of less than or equal to 55% and even in patients who had failed to receive chemotherapy. Baseline ¹⁸F-FDG was useful in combination with SSTR molecular imaging to stratify G3 NEN patients with high uptake on SSTR PET/CT and no or minor ¹⁸F-FDG avidity—a mismatch pattern that was related to a better long-term prognosis.