What are the NCCN guidelines on the treatment of metastatic pancreatic neuroendocrine tumors (NETs)?

Updated: Dec 23, 2018
  • Author: Evan S Ong, MD, MS; more...
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NCCN recommendations for the treatment of unresectable and/or metastatic pancreatic tumors include the following [7] :

  • Limited hepatic metastases: Complete resection of primary tumor and metastases with curative intent; noncurative debulking surgery in select cases

  • Asymptomatic unresectable disease: For select patients with low tumor burden and stable disease, consider observation with marker assessment and imaging every 3-12 months until significant disease progression occurs; lanreotide or octreotide can be considered

  • Symptomatic unresectable disease: Octreotide or lanreotide; everolimus or sunitinib; or cytotoxic chemotherapy

  • Hepatic-directed therapies include cytoreductive surgery or ablative therapy; bland hepatic arterial embolization, radioembolization, and chemoembolization are additional options but the optimal embolization technique has not been determined

  • Liver transplantation is investigational and not recommended as routine care

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