Do you have a preferred systemic agent for patients with metastatic, unresectable, functional neuroendocrine tumors, such as an insulinoma, if the goal is to get a quick response?
Answer from: Medical Oncologist at Community Practice
The management of metastatic unresectable neuroendocrine tumors depends on many factors including functionality, tumor burden, primary tumor, and SS expression. Usually, part of the management will be SSA to control hormonal secretion, however, we should be careful in patients with insulinoma. While...
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Answer from: Medical Oncologist at Academic Institution
I agree with what has been said above and I have the following additional comments. After obtaining somatostatin receptor imaging with DOTATATE PET and confirmed DOTATATE avidity (presence of somatostatin receptors), I typically start a somatostatin analog such as lanreotide or octreotide and I...
Comments
Medical Oncologist at Bon Secours Saint Mary's Hospital
Thank you for your detailed response. If the Ki67 ...
Thank you for your detailed response. If the Ki67 ...
Medical Oncologist at Mayo Clinic
That Ki67 proliferative index puts it squarely int...
That Ki67 proliferative index puts it squarely int...
Medical Oncologist at Bon Secours Saint Mary's Hospital
Thank you. This is very helpful!
Thank you. This is very helpful!
Answer from: Medical Oncologist at Academic Institution
Agree with everything that has been discussed here. I learned a "pearl" from my mentor @Thorvardur (Thor) R. Halfdanarson which is dexamethasone. I have had success in two patients with dexamethasone as a temporizing measure. Of note, steroids downregulate SSTR so that could be relevant if consideri...