The protocol was amended to include the following main changes: ● The definitions of PFS, TTP, and OS were modified so that they were based on the time from the date of randomization, instead of the time from the date of first treatment ● The exclusion criteria were supplemented with the criterion ‘lactation’ ● Clarification about safety assessments and the performance of additional safety assessments regarding blood chemistry and urine tests was added to the study schedule for both treatment groups ● Instructions were added to ensure that laboratory parameters met required treatment criteria before administration of study drug, and participant observation after treatment with the study drug was extended ● Further details on the DSMB role and activities were added ● Further details on the substudy conduct and data analysis were implemented ● Appendices 15 (Recommended Precautions for Participants Treated with 177Lu-DOTA0-Tyr3-octreotate (Lutathera)) and 17 (Randomization Procedure of Participants after Enrolment) were modified and Appendix 19 (Determination of Lutathera Administered Radioactivity) were added to the protocol.

The protocol was amended to include the following main changes: ● Per FDA request, the biased coin randomization scheme was replaced by a stratified permuted block randomization scheme with a balanced ratio (1:1) between the 2 treatment groups and the stratification for specific center enrolment was deleted (at the time of the randomization scheme change, 28 participants were already randomized) ● The method to control the family-wise type I error rate for OS and ORR was included as well as a detailed description of the statistical analysis for OS ● The end of study definition was modified and the description of the primary analysis adapted accordingly ● Participant replacement for the primary analysis was excluded and the primary log-rank test further specified ● Clarifications were added regarding the conduct of the urinalysis, the CT/MRI timings, the allowed tumor location, the study population characteristics, timing and procedures of the OctreoScan®, and the allowed time-windows for the Octreotide LAR injections ● Discontinuation criteria for individual participants were specified in more detail ● Further options for additional allowed amino acid solutions, details on the drug administration procedures in the Octreotide LAR group, details about the administration procedures of rescue medication, and details about the handling of study medication were added ● Further details on SAE and AESI reporting were included.

The protocol was amended to include the following main changes to the conduct and procedures of the NETTER-1 substudy: ● Additional details on the dosimetry substudy procedures were added with regard to the performance of further optional dosimetry ● The number of sites participating in the substudy was increased.

The protocol amended to include these main changes: ● Sample size adjusted, follow-up period increased from 3 to 5 years to detect statistically significant and clinically relevant difference in OS between the 2 study groups ● Study design adapted so that primary analysis conducted after 74 PFS events (74 centrally confirmed disease progression or death events) ● Secondary endpoints of DoR and PFS2 added as exploratory objectives ●End of Study (EOS) defined as reaching 158 deaths or 5 years had elapsed since the date of randomization of the last randomized participant, whichever occurred first ● Specifications added for the use of unstratified log-rank test in the primary analysis of PFS ● Details added on Dose Modifying Toxicity criteria and procedures ● Timing for safety assessments adapted to comply with new EOS ● Flowcharts and visits of the treatment/assessment period were adapted to comply with the new study design ● Substudy exclusion criteria regarding subsequent treatments modified ● Definitions regarding screening failures, study termination, and study withdrawal were added to the discontinuation criteria for individual participants ● A description about the handling of discrepancies in the evaluation of the progressive status between Investigator and central assessor added ● Clarification on procedures for dropouts, replacements and deliberate treatment interruption added ● Details on Octreotide LAR administration added ● Details on supportive information from histology added, clarifications on the CT/MRI scan timing and procedures, specifications on concomitant medication collection ● Recommendations added regarding amino acids solution infusion for treatment of nausea/vomiting and the use of anti-emetics ● Substudy updated with additional information on ECG assessments, collection of physical examination, vital signs, timing of the exams in relation to the 177Lu-DOTA0-Tyr3-octreotate treatment, dosimetry, PK, and cardiac assessments

The protocol was amended to include the following main changes to the conduct and procedures of the substudy: ● Recruitment, randomization, and data analysis details for the substudy were specified.