We report the results of the first multicentric randomized open-label non-comparative phase II study assessing PRRT-177Lu-Octreotate antitumor efficacy (OCLU, OCLURANDOM trial: EudraCT N o : 2013-004032-30). Patients (pts) with progressive advanced PaNET according to RECIST1.1 were randomized 1:1 to OCLU (7.4 GBqX4/8w) or sunitinib (SUN) 37.5 mg/d. Primary endpoint was: progression-free survival (PFS) rate at 12 months according to RECIST 1.1 real-time central review. The sample size calculation of the OCLU arm assumed a 25% increase (from 35% to 60%) of the 12-m PFS rate. 40 pts had to be included in a single stage Fleming design with type I error = type II error = 5%. The SUN group served as an internal control to validate the null hypothesis with a 12 months PFS rate of 35%. 84 pts were enrolled. Main characteristics were well balanced. The primary endpoint was met with a 12m-PFS rate at 80.5% in the OCLU arm (IC90%: 67.5–89.9, n = 33 pts without progression at 12 months/41) vs. 41.9% in the SUN arm (IC90%: 29.1–55.5,including 35% the null hypothesis; n = 18/43). Median PFS was 20.7 in the OCLU arm (90CI: 17.2–23.7) vs. 11 months in the SUN arm (90CI: 8.8–12.4). The OCLURANDOM study met its primary endpoint.