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Jennifer R Eads Division of Hematology and Oncology, Abramson Cancer Center, University of Pennsylvania, Pennsylvania, USA

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Thorvardur R Halfdanarson Division of Medical Oncology, Mayo Clinic Cancer Center, Rochester, Minnesota, USA

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Tim Asmis Division of Medical Oncology, University of Ottawa, Ottawa, Ontario, Canada

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Andrew M Bellizzi Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA

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Emily K Bergsland Department of Medicine, University of California, San Francisco, California, USA

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Arvind Dasari Division of Gastrointestinal Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Ghassan El-Haddad Department of Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA

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Michael Frumovitz Division of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

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Joshua Meyer Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

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Erik Mittra Division of Molecular Imaging and Therapy, Oregon Health & Science University, Portland, Oregon, USA

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Sten Myrehaug Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

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Eric Nakakura Department of Surgery, University of California, San Francisco, California, USA

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Nitya Raj Department of Medicine, Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Heloisa P Soares Division of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Salt Lake City, Utah, USA

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Brian Untch Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Namrata Vijayvergia Department of Hematology and Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA

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Jennifer A Chan Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA

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Introduction High-grade neuroendocrine neoplasms (NENs) constitute a rare disease entity and account for approximately 10% of all NENs. Given their rarity, there is a paucity of prospective data to guide the optimal diagnosis and management of

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Andreas Venizelos K.G. Jebsen Center for Genome-Directed Cancer Therapy, Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Oncology, Haukeland University Hospital, Bergen, Norway

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Hege Elvebakken Department of Oncology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

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Aurel Perren Institute of Pathology, University of Bern, Bern, Switzerland

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Oleksii Nikolaienko K.G. Jebsen Center for Genome-Directed Cancer Therapy, Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Oncology, Haukeland University Hospital, Bergen, Norway

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Wei Deng K.G. Jebsen Center for Genome-Directed Cancer Therapy, Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Oncology, Haukeland University Hospital, Bergen, Norway

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Inger Marie B Lothe Department of Pathology, Oslo University Hospital, Oslo, Norway

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Anne Couvelard Department of Pathology, Université de Paris, Bichat Hospital, AP-HP, Paris, France

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Geir Olav Hjortland Department of Oncology, Oslo University Hospital, Oslo, Norway

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Anna Sundlöv Departmentt of Oncology, Skåne University Hospital, Lund, Sweden
Department of Medical Radiation Physics, Lund University, Lund, Sweden

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Johanna Svensson Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Harrish Garresori Department of Oncology, Stavanger University Hospital, Stavanger, Norway

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Christian Kersten Department of Research, Hospital of Southern Norway, Kristiansand, Norway

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Eva Hofsli Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
Department of Oncology, St.Olavs Hospital, Trondheim, Norway

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Sönke Detlefsen Department of Pathology, Odense University Hospital, Odense, Denmark
Department of Clinical Medicine, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

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Merete Krogh Department of Oncology, Odense University Hospital, Odense, Denmark

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Halfdan Sorbye Department of Oncology, Haukeland University Hospital, Bergen, Norway
Department of Clinical Science, University of Bergen, Bergen, Norway

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Stian Knappskog K.G. Jebsen Center for Genome-Directed Cancer Therapy, Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Oncology, Haukeland University Hospital, Bergen, Norway

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Introduction High-grade (HG) gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are defined by the presence of neuroendocrine phenotype and a high proliferation rate (Ki-67 > 20%). The HG NEN entity consists of well

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Halfdan Sorbye Department of Oncology, Haukeland University Hospital, Bergen, Norway
Department of Clinical Sciences, University of Bergen, Bergen, Norway

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Grace Kong Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Australia

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Simona Grozinsky-Glasberg Neuroendocrine Tumor Unit, ENETS Center of Excellence, Department of Endocrinology and Metabolism, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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-term toxicity. 177 Lu-DOTA-octreotate (LuTathera) has recently obtained regulatory approval for patients with progressive metastatic grade 1–2 GEP NET. High-grade gastroenteropancreatic neuroendocrine neoplasms: NET G3 and NEC Gastroenteropancreatic

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A Mohamed Division of Hematology and Medical Oncology, UH Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA

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M Trybula Division of Hematology and Medical Oncology, UH Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA

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S L Asa Department of Medicine, UH Seidman Cancer Center Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA

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T R Halfdanarson Division of Medical Oncology, Department of Oncology, Mayo Clinic Comprehensive Cancer Center, Rochester, Minnesota, USA

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M B Sonbol Division of Hematology and Medical Oncology, Mayo Clinic Cancer Center, Phoenix, Arizona, USA

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al. 2022 ). This classification was broadened to include all NENs regardless of the primary tumor origin in the 2022 WHO classification (2022). G3 GEP-NETs, characterized by both well-differentiated and high-grade features (Ki-67 > 20%), exhibit a

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Esben Andreas Carlsen Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark
Department of Biomedical Sciences, Cluster for Molecular Imaging, University of Copenhagen, Copenhagen, Denmark

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Nicola Fazio Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy

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Dan Granberg Department of Medical Sciences, Uppsala University, Uppsala, Sweden

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Simona Grozinsky-Glasberg Neuroendocrine Tumor Unit, Department of Endocrinology & Metabolism, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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Hojjat Ahmadzadehfar Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany

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Chiara Maria Grana Division of Nuclear Medicine, IEO, European Institute of Oncology IRCCS, Milan, Italy

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Wouter T Zandee Erasmus Medical Center, Rotterdam, The Netherlands

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Jaroslaw Cwikla Medical School, University of Warmia and Mazury, Olsztyn, Poland

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Martin A Walter Department of Nuclear Medicine, University Hospital of Geneva, Geneva, Switzerland

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Peter Sandor Oturai Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark

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Anja Rinke Department of Gastroenterology, University Hospital Gießen and Marburg, Marburg, Germany

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Andrew Weaver Department of Oncology, Churchill Hospital, Oxford, UK

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Andrea Frilling Department of Surgery and Cancer, Imperial College London, London, UK

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Sara Gritti Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy

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Anne Kirstine Arveschoug Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark

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Amichay Meirovitz Department of Oncology and Radiation Therapy Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

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Ulrich Knigge Department of Biomedical Sciences, Cluster for Molecular Imaging, University of Copenhagen, Copenhagen, Denmark
Departments of Surgical Gastroenterology and Clinical Endocrinology, Rigshospitalet, Copenhagen, Denmark

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Halfdan Sorbye Department of Oncology, Haukeland University Hospital, Bergen, Norway
Department of Clinical Science, University of Bergen, Bergen, Norway

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poorly differentiated high-grade neuroendocrine carcinomas (G3). The terminology of NEN G3 relates to all high-grade (G3, Ki-67 >20%) neuroendocrine malignancies; i.e. both NET G3 and NEC. Gastroenteropancreatic (GEP) NENs G3 are rare, highly malignant

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Cecile N Chougnet Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Sophie Leboulleux Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Caroline Caramella Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Jean Lumbroso Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Isabelle Borget Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Désirée Déandreis Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Pierre Duvillard Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Dominique Elias Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Thierry de Baere Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Fritz-Line Vélayoudom-Céphise Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Joël Guigay Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Michel Ducreux Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Martin Schlumberger Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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Eric Baudin Departments of Nuclear Medicine and Endocrine Tumors, Medical Imaging, Biostatistics and Epidemiology, Pathology, Oncologic Surgery, Department of Endocrinology, Departments of Medical Oncology, Digestive Oncology

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or PET status ( Garin et al . 2009 , Binderup et al . 2010 a ). More precisely, high-grade of SRS uptake was recently found to carry prognostic information ( Imhof et al . 2011 ). However, in the absence of randomized study, the respective

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Thomas Yang Sun Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA

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Lan Zhao Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA

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Paul Van Hummelen Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA

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Brock Martin Department of Pathology, Stanford University School of Medicine, Stanford, California, USA

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Kathleen Hornbacker Clinical Trials Office, Stanford University, Stanford, California, USA

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HoJoon Lee Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA

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Li C Xia Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
Division of Biostatistics, Department of Epidemiology and Public Health, Albert Einstein College of Medicine, Bronx, New York, USA

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Sukhmani K Padda Cedars-Sinai Medical Center, Department of Medical Oncology, Los Angeles, California, USA

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Hanlee P Ji Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
Stanford Genome Technology Center, Stanford, California, USA

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Pamela Kunz Yale School of Medicine, Smilow Cancer Hospital, Yale Cancer Center, New Haven, Connecticut, USA

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, high-grade (grade 3, G3) NENs have an OS of only about 7 months ( Dasari et al. 2017 , 2018 ). These G3 NENs are rare, with an annual incidence of 10.52 per 100,000 worldwide ( Leoncini et al. 2017 ). They are most often poorly differentiated but

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Andreas Venizelos K.G. Jebsen Center for Genome-Directed Cancer Therapy, Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Oncology, Haukeland University Hospital, Bergen, Norway

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Halfdan Sorbye Department of Oncology, Haukeland University Hospital, Bergen, Norway
Department of Clinical Science, University of Bergen, Bergen, Norway

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Hege Elvebakken Department of Oncology, Ålesund Hospital, Møre og Romsdal Hospital Trust, Ålesund, Norway
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

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Aurel Perren Institute of Tissue Medicine and Pathology, University of Bern, Bern, Switzerland

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Inger Marie B Lothe Department of Pathology, Oslo University Hospital, Oslo, Norway

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Anne Couvelard Department of Pathology, Université Paris Cité and AP-HP, Bichat Hospital, Paris, France

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Geir Olav Hjortland Department of Oncology, Oslo University Hospital, Oslo, Norway

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Anna Sundlöv Departmentt of Oncology, Skåne University Hospital, Lund, Sweden
Department of Medical Radiation Physics, Lund University, Lund, Sweden

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Johanna Svensson Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Harrish Garresori Department of Oncology, Stavanger University Hospital, Stavanger, Norway

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Christian Kersten Department of Research, Hospital of Southern Norway, Kristiansand, Norway

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Eva Hofsli Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
Department of Oncology, St. Olavs Hospital, Trondheim, Norway

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Sönke Detlefsen Department of Pathology, Odense University Hospital, Odense, Denmark
Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark

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Lene W Vestermark Department of Oncology, Odense University Hospital, Odense, Denmark

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Morten Ladekarl Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark

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Elizaveta Mitkina Tabaksblat Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark

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Stian Knappskog K.G. Jebsen Center for Genome-Directed Cancer Therapy, Department of Clinical Science, University of Bergen, Bergen, Norway
Department of Oncology, Haukeland University Hospital, Bergen, Norway

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Introduction Neuroendocrine neoplasms (NENs) constitute ~2% of all malignancies and are frequently located in the gastrointestinal (GI) tract and pancreas. High-grade gastroenteropancreatic (HG-GEP) NENs are among the most aggressive cancers

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Alicia A Tone The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9
The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9
The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9
The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9

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Carl Virtanen The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9

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Patricia A Shaw The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9
The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9
The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9

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Theodore J Brown The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9
The Samuel Lunenfeld Research Institute, Department of Laboratory Medicine and Pathobiology, Department of Obstetrics and Gynecology, Department of Pathology, Microarray Centre, Mount Sinai Hospital, University of Toronto, 60 Murray Street, PO Box 41, Toronto, Ontario, Canada M5T 3L9

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epithelium (OSE), accumulating evidence provides strong support that high-grade serous adnexal cancer, commonly attributed to an ovarian origin, arises from the distal fallopian tube epithelium (FTE; Colgan et al . 2001 , Piek et al . 2001 , Finch et al

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Zhigang Zhao Department of Urology of Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical College, No. 1–3, Kangda Road, Guangzhou 510230, Guangdong Province, People's Republic of China

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Guohua Zeng Department of Urology of Minimally Invasive Surgery Center, the First Affiliated Hospital of Guangzhou Medical College, No. 1–3, Kangda Road, Guangzhou 510230, Guangdong Province, People's Republic of China

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Introduction High-grade prostatic intraepithelial neoplasia (HGPIN) is currently accepted as a risk factor for the delayed progression to prostate cancer (PCa; Dovey et al . 2005 , Ayala & Ro 2007 , Chin et al . 2007 , Montironi et al . 2007

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