Treatment of Neuroendocrine Tumors (NETs) With Combination of Everolimus and Radiolabeled Somatostatin Analogue

Inclusion Criteria: * Age \> 18 years old. * Histologically confirmed well to moderately differentiated neuroendocrine tumors of GI, lung or pancreatic origin. The grading follows the WHO grading system (Appendix III). * Measurable disease by CT or MRI. * Positive Tc-99m Octreotide scan or Ga-68 Octreotate scan (Positive means uptake at tumor sites). * Advanced disease which are not treatable by surgical resection. * Documented progressive disease within the past 12 months. * WHO Performance Status 0 - 2. * Fasting blood sugar ≤ 1.5 Χ Upper Limit of Normal (ULN). * Fasting triglycerides ≤ 2.5 Χ Upper Limit of Normal (ULN), and fasting cholesterol ≤ 300 mg/dl or ≤ 7.75 ml/l. * Adequate renal function with creatinine clearance ≥ 60 ml/l. * Adequate hepatic function: * Total bilirubin ≤ 1.5 Χ Upper Limit of Normal (ULN) * Liver Function Tests (Serum aspartate aminotransferase and alanine transaminase levels) ≤ 2.5 Χ ULN (and ≤ 5 Χ ULN, in case of presence of liver metastasis) * Adequate hematological values: * Absolute neutrophil count ≥ 1 x 109/L * Platelet count ≥ 100 x 109/L * Signed written informed consent before enrolment. Exclusion Criteria: * Readily completely Resectable disease. * Prior therapy with everolimus or systemic chemotherapy. * Prior chemoembolization, radio-embolization, or bland embolization within 6 months before enrolment. Likewise, patients are ineligible if had undergone conventional radiotherapy, radiofrequency ablation, cryoablation or alcohol injection within 1 month prior to enrolment. * Prior long acting somatostatin analogue within 1 month prior to enrolment. Short acting somatostatin analogue is allowed as long as it is not administered within 12 hours before or /and 12 hours after the administration of the intravenous radiolabelled Lu-177 DOTATATE Therapy. * Presence of Central Nervous System metastasis. * Previous malignancy within 5 years, except adequately treated non melanomatous skin cancer or in situ cervical cancer * Other active malignancy. * HIV infection. * Severe or uncontrolled medical conditions, such as: * Active uncontrolled severe infection * History of invasive fungal infection. * Child C liver dysfunction. * Severely impaired lung function. * Psychiatric or mental disorder, precluding understanding of the information of the trial related topics and giving valid informed consent. * Any psychological, familial, geographic or social circumstances which could impair the patient's ability to participate in the trial and comply with follow up. * Treatment with other anti-cancer therapy. * Known hypersensitivity to any of the study drugs. * Pregnant or breast feeding women.