Dr. Iqbal on Treatment Options for Patients With Neuroendocrine Tumors

Syma Iqbal, MD, associate professor of clinical medicine, Keck School of Medicine, University of Southern California, discusses treatment options for patients with neuroendocrine tumors (NETs).

NETs used to be a very rare malignancy, but the incidence has been increasing and physicians are seeing more cases, says Iqbal. Luckily, physicians have more treatment options now than before. The introduction of somatostatin analogues and peptide receptor radionucleotide therapy (PRRT) have transformed the field, explains Iqbal. In January 2018, Lutathera (lutetium Lu 177 dotate) was FDA approved for patients with somatostatin receptor—positive gastroenteropancreatic NETs.

Moreover, clinical trials have demonstrated the activity of targeted therapies, mTOR inhibitors, and VEGF inhibitors, but physicians do not yet have a clear picture of how to sequence these therapies, says Iqbal. A patient who has well-differentiated low-grade disease is going to live a very long time, but they are probably going to go progress through multiple lines of treatment, says Iqbal, further underscoring the need to determine the best sequence of therapies.