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The number of patients with neuroendocrine tumors (NETs) receiving treatment in the community setting is beginning to increase, with the approval of new therapies and the development of effective guidelines. In many cases, Rodney F. Pommier, MD, explains, patients are receiving treatment recommendations from a multidisciplinary team at a cancer center prior to receiving treatment in a community practice.
Given the inherent difficulties in the management of NETs, a unique multidisciplinary team is required to guide treatment decisions. In addition to surgical and medical oncologists, Pommier believes the team should include interventional radiologists, endocrinologists, nuclear medicine experts, cardiologists, and medical geneticists. Another important member, Pamela L. Kunz, MD adds, are pathologists, particularly given the importance of histology.
The panel recommends continued communication between local oncologists and larger centers. This approach aligns with the scarce data available on treatment sequences, Pommier believes. In general, he feels, it is best for a multidisciplinary team to see the patient first, since it is possible to provide an upfront treatment that may lower the chances of a successful surgical resection.
The initial treatment should be tailored on an individual patient basis, James C. Yao, MD, stresses. With the availability of new agents it is possible for patients to receive treatment closer to home, which most patients prefer, Yao notes. However, despite the influx of new agents, there is still a large unmet need in this space calling for more clinical trials, Yao notes.