Issues to consider when selecting first‐line treatment for patients with NET G3 include Ki‐67 (chemotherapy may be more appropriate for Ki‐67 >30%–40%), tumour growth rate (slower growth rate favours PRRT), primary site (pancreatic NET more responsive to chemotherapy), time to response (likely quicker with chemotherapy) and symptom burden (rapid access to chemotherapy). Here, MKI67 is linked to pancreatic neuroendocrine tumor.