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Herein, we review the many factors that affect patient selection, focusing on the optimal patients to treat. Although significant effort has been expended to determine which patients benefit the most from PRRT, a validated predictive biomarker remains elusive. Although PRRT has been used for more than 2 decades in Europe and standards of care exist for safe treatment, there remain numerous questions regarding when PRRT should be used relative to other treatments. It is important to remember that multidisciplinary discussions are essential. Currently, there are a number of ongoing studies looking to assess the efficacy of PRRT compared with other treatment options and to optimize treatment through combination therapy, different dosing strategies, or use of different radionuclides and radioligands. <\/jats:p>","DOI":"10.1200\/jco.22.00176","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T19:59:23Z","timestamp":1654113563000},"page":"2818-2829","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":38,"title":["Neuroendocrine Tumors and Peptide Receptor Radionuclide Therapy: When Is the Right Time?"],"prefix":"10.1200","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-5823","authenticated-orcid":false,"given":"Thomas A.","family":"Hope","sequence":"first","affiliation":[{"name":"Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA"},{"name":"Helen Diller Family 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