Treatment Guideline Recommendations for Neuroendocrine Tumors

Video content above is prompted by the following:

NCCN Guidelines and Cabozantinib’s Role

Key Themes:

• NCCN Guideline Integration:
• Cabozantinib now incorporated into NCCN guidelines

• Category 1 recommendation for GI NETs if prior treatment with everolimus or lutetium-177 dotatate

• Category 1 for pancreatic NETs if prior therapy with everolimus, lutetium-177 dotatate, or sunitinib
• Lung and Thymic NETs Considerations:
• About half of lung NETs lack homogeneous somatostatin receptor expression

• Limited treatment options for lung NETs make cabozantinib particularly valuable

• Everolimus is approved for lung NETs; temozolomide with capecitabine has some activity based on limited data

Notable Insights:

Dr Halfdanarson highlighted that for lung NETs without somatostatin receptor expression, cabozantinib provides a valuable option, though he would still typically use somatostatin analogues or everolimus first when feasible.