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Therapies

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OVERVIEW

Therapies

Different therapies or drugs are used to slow or stop the growth of neuroendocrine cancer cells. Close to half of patients who have a NET report using drug therapies other than chemotherapy, including somatostatin analogs. Fewer patients (about 1 in 5) reported being treated with chemotherapy.

SOMATOSTATIN ANALOG THERAPY

Hormone therapy with a somatostatin analog may stop an excess of hormones from being released by NETs, which can improve quality of life. Somatostatin analog injections may improve symptoms and, in some patients, may help slow tumor growth but cannot cure them.

The side effects can be relatively mild and may include nausea, cramping, loose stools,
abnormal stools (steatorrhea), and changes in heart rate. Given by injection, somatostatin analogs are available in long- and short-acting formulations and include:

  • Octreotide
  • Lanreotide

TARGETED THERAPY

Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming healthy cells. 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. For NETs, a few targeted therapies have been approved by the U.S. Food and Drug Administration (FDA), which are:

  • Everolimus
  • Sunitinib

Other types of targeted therapies are being studied to treat NETs.

CHEMOTHERAPY

Chemotherapy can stop the growth of cancer by either killing cancer cells or stopping their division. Taken by mouth or injected, chemotherapy drugs enter the bloodstream and reach cancer cells throughout the body.

Sometimes, 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 chemotherapy drugs used to treat NETs include:

  • Capecitabine
  • Carboplatin
  • Cisplatin
  • Dacarbazine
  • Doxorubicin
  • Etoposide
  • 5-fluorouracil
  • Oxaliplatin
  • Streptozocin
  • Temozolomide

IMMUNOTHERAPY

Immunotherapy involves using a patient’s own immune system to fight cancer. At present, immunotherapy is more commonly used in other cancer types. NETRF is funding studies to learn more about the role immunotherapy can play in treating NETs.

INTERVENTIONAL RADIOLOGY

Interventional radiology is a minimally invasive approach to treat neuroendocrine cancer that has spread to the liver. Often called liver-directed therapy, this approach starves liver tumors by denying them the nutrients they require to grow.

HEPATIC ARTERIAL EMBOLIZATION

Hepatic arterial therapy reduces or blocks the flow of blood to stop cancer cells from getting the oxygen and nutrients they require to grow. The sources of blood to the liver are the portal vein and hepatic artery.

Hepatic embolization blocks or reduces the flow of blood in the hepatic artery to kill cancer cells growing in the liver. The portal vein continues to supply blood to the liver. There are two types of hepatic embolization:

  • Bland embolization: injection of embolic particles, such as tiny gelatin sponges or beads to reduce blood flow
  • Chemoembolization (TACE): injection of embolic particles (to reduce blood flow) that are mixed with chemotherapy (to kill tumor cells) or the direct infusion of chemotherapy in the artery by use of a catheter

RADIOEMBOLIZATION

Radioembolization combines embolization with radiation therapy to kill tumor cells in the liver. A doctor injects millions of radioactive microspheres (or microscopic beads) into the hepatic artery, which then emit radiation to kill tumor cells.

RADIOFREQUENCY ABLATION (RFA)

Radiofrequency ablation (RFA) uses an electrical current to destroy tumor cells. RFA involves placing a small probe into a tumor to raise the tumor temperature and destroy it. RFA can be done laparoscopically but is more commonly done in combination with liver resection.

treatment of nets

Learn more about these treatments.

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Treatment of NETs Overview