Systemic Treatments for NETs: Whom to Treat and How to Sequence

Christina T. Loguidice
Published: Thursday, May 02, 2019
Jonathan Strosberg, MD

Jonathan Strosberg, MD
Although novel therapeutic strategies have shown potential in recent clinical trials, somatostatin analogs are still the frontline standard of care for gastroenteropancreatic neuroendocrine tumors (GEP-NETs), said Jonathan R. Strosberg, MD.

Although several recently approved systemic treatments are helping to improve outcomes for patients with neuroendocrine tumors (NETs), a highly heterogeneous tumor type that historically has had few treatment options, these agents have led to the conundrum of how to optimally sequence treatments. During a recent OncLive Peer Exchange® discussion, NET experts Simron Singh, MD, MPH, and Jonathan R. Strosberg, MD, provided insight on which patients are the best candidates for these approved treatments and how to sequence therapy to optimize outcomes. They also discussed data for several agents under investigation, including various immunotherapies and the novel targeted agent lenvatinib (Lenvima).

NETs are rare, making up <3% of all malignancies.1 In the United States, the prevalence is <200,000 cases, with an estimated 12,000 new NETs diagnosed annually.1,2 However, data from the Surveillance, Epidemiology, and End Results program suggest that incidence and prevalence of NETs are steadily rising.3 Between 1973 and 2012, the age-adjusted incidence rate was observed to increase 6.4-fold, from 1.09 per 100,000 to 6.98 per 100,000, respectively.3 This increase was observed across all sites, stages, and grades but was most prevalent in early-stage disease. The study investigators attributed the increased incidence and prevalence to better detection of early-stage disease and improved overall survival (OS) from recent treatment advances, particularly for distant-stage gastrointestinal (GI) and pancreatic NETs.3

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Online CME Activities
TitleExpiration DateCME Credits
Oncology Briefings™: Individualizing Treatment After Second-Line Therapy for Patients With mCRCAug 29, 20191.0
Community Practice Connections™: Navigating New Sequencing Challenges for the Treatment of Hepatocellular CarcinomaAug 30, 20191.5
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