Therapies for Neuroendocrine Tumors

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Different therapies or drugs are used to slow or stop the growth of neuroendocrine cancer cells. Close to half of NET patients report using drug therapy other than chemotherapy.2  About 1 in 5 patients were treated with chemotherapy.2

Somatostatin Analogs

Hormone therapy with a somatostatin analog may stop an excess of hormones from being made, which can improve people’s quality of life with relatively mild adverse effects.23  Side effects include nausea, cramping, loose stools, abnormal stools (steatorrhea), and changes in heart rate.24  Somatostatin analogs are available in long- and short-acting formulations, delivered by injection.

OCTREOTIDE
LANREOTIDE

Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. A targeted therapy changes the way cancer cells grow, divide, and spread. For example, they may block or turn off signals to make more cancer cells.  A few targeted therapies are approved for use in NETs:

EVEROLIMUS
SUNITINIB

Certain types of targeted therapies are being studied in the treatment of NETs that target NETs including VEGF monoclonal antibodies and VEGF tyrosine kinase inhibitors.

Chemotherapy

Chemotherapy can stop the growth of cancer cells, either by killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and reach cancer cells throughout the body. One or more chemotherapy drugs may be used together. The way the chemotherapy is given depends on the type of tumor being treated. Some of the chemotherapies used to treat NETs include:5,13

CAPECITABINE
CARBOPLATIN
CISPLATIN
DACARBAZINE
DOXORUBICIN
ETOPOSIDE
FLUOROURACIL
OXALIPLATIN
IRINOTECAN HYDROCHLORIDE
STREPTOZOCIN
TEMOZOLOMIDE

Immunotherapy

Immunotherapy is a type of cancer treatment that helps the body’s immune system fight cancer. NETRF is funding studies to learn more about the role immunotherapy can play in treating NETs. Immunotherapy is more commonly used in other cancer types. The one treatment being used for NETs is:5,13

INTERFERON ALFA-2B
Mark Lewis, MD, Intermountain Healthcare

Mark Lewis, MD, Intermountain Healthcare

Targeted Therapy and Chemotherapy for NETs Watch Video
Drs. Tom and Sue O’Dorisio, University of Iowa Learn

Drs. Tom and Sue O’Dorisio, University of Iowa Learn

A look at common hormonal therapies for NETs. Watch Video
Heloisa Soares, MD, PhD, University New Mexico

Heloisa Soares, MD, PhD, University New Mexico

Functional vs. Nonfunctional Tumors Watch Video
Pam Kunz, MD, Stanford University

Pam Kunz, MD, Stanford University

What about immunotherapy? Watch Video

2Singh S, Granberg D, Wolin E, et al. Patient-reported burden of a neuroendocrine tumor (NET) diagnosis: results from the first global survey of patients with NETs. J Glob Oncol. 2016;2(1):43-53.

5Frilling A, Akerström G, Falconi M, et al. Neuroendocrine tumor disease: an evolving landscape. Endocrine-Related Cancer. Endocr-Rel Caner. 2012;19(5):163-185.

13National Cancer Institute. Pheochromocytoma and paraganglioma treatment (PDQ®)-patient version. 2017. https://www.cancer.gov/types/pheochromocytoma/patient/pheochromocytoma-treatment-pdq. Accessed October 23, 2018. 

23Modlin IM, Latich I, Kidd M, et al. Therapeutic options for gastrointestinal carcinoids. Clin Gastroenterol Hepatol. 2006; 4(5): 526-47, 2006. 

25 National Cancer Institute. Phases of clinical trials.. https://www.cancer.gov/types/gi-carcinoid-tumors/hp/gi-carcinoid-treatment-pdq#cit/section_4.1 Accessed December 21, 2018.