Treatment Guideline Recommendations for Neuroendocrine Tumors
A panelist discusses how NCCN guidelines now include cabozantinib as a category 1 recommendation for gastrointestinal (GI) neuroendocrine tumors (NETs) after prior treatment with everolimus or lutetium-177 dotatate, with slightly different recommendations for pancreatic, lung, and thymic NETs.
Video content above is prompted by the following:
NCCN Guidelines and Cabozantinib’s Role
Key Themes:
- NCCN Guideline Integration:
- Cabozantinib now incorporated into NCCN guidelines
- Category 1 recommendation for GI NETs if prior treatment with everolimus or lutetium-177 dotatate
- Category 1 for pancreatic NETs if prior therapy with everolimus, lutetium-177 dotatate, or sunitinib
- Lung and Thymic NETs Considerations:
- About half of lung NETs lack homogeneous somatostatin receptor expression
- Limited treatment options for lung NETs make cabozantinib particularly valuable
- Everolimus is approved for lung NETs; temozolomide with capecitabine has some activity based on limited data
Notable Insights:
Dr Halfdanarson highlighted that for lung NETs without somatostatin receptor expression, cabozantinib provides a valuable option, though he would still typically use somatostatin analogues or everolimus first when feasible.
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