Treatment Options for Patients with Neuroendocrine Tumors
A panelist discusses how first-line treatment options for neuroendocrine tumors depend on tumor grade, disease extent, and symptoms, ranging from observation for asymptomatic cases to somatostatin analogues, chemotherapy, and the newly approved cabozantinib.
Video content above is prompted by the following:
First-Line Treatment Options for Neuroendocrine Tumors
Key Themes:
- Treatment Decision Factors:
- Treatment approach driven by tumor grade, disease extent, and presence of symptoms
- Observation may be appropriate for asymptomatic, low-grade, low tumor burden cases
- Localized disease may require surgery based on symptoms (bleeding, obstruction)
- Systemic Therapy Options:
- Monthly somatostatin analogue injections (long-acting octreotide or lanreotide) as typical first-line therapy for tumors positive on somatostatin-receptor PET imaging
- Chemotherapy with capecitabine/temozolomide for symptomatic pancreatic neuroendocrine tumors
- Peptide receptor radionuclide therapy with lutetium-177 dotatate (Lutathera) for tumors with Ki-67 ≥10%
- Emerging Treatments:
- Cabozantinib is newly approved for neuroendocrine tumors, particularly beneficial for pancreatic, lung, and small bowel NETs
Notable Insights:
Dr Halfdanarson highlighted that small, well-differentiated pancreatic NETs (<2 cm) are increasingly being observed rather than immediately surgically resected, representing a shift in management approach.
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