What Are Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs)?

Kim says treatment of GEP-NETs depends on a multitude of factors, such as:

• Primary site of tumor
• Tumor grade
• Tumor stage
• Patient age
• Comorbidities

Surgery

If a tumor is localized, she says, endoscopic or surgical treatment is always the first choice. If a tumor is more widespread, a combination of treatments is usually the way to go.

The type of surgery depends on where the tumor is located and how big and aggressive it is. Sometimes doctors need to remove nearby organs as well.

• Radiofrequency Ablation A special probe with small electrodes kills cancer cells.
• Cryoablation Tissue is frozen to destroy cancer cells.
• Tumor Debulking A surgeon removes parts of the tumor that are producing too many hormones.
• Hepatic Artery Embolization The doctor injects a contrast dye and small particles into the hepatic artery (the major vessel that delivers blood to the liver) to stop its blood supply from reaching the tumor.

  [15]

• Chemoembolization The doctor injects chemotherapy medicine into the hepatic artery during a hepatic artery embolization procedure.

  [16]

Drug Treatment

• Somatostatin Analogs The drugs octreotide (Sandostatin) and lanreotide (Somatuline Depot) can improve symptoms caused by some types of functional GEP-NETs and may also stabilize tumor growth. These medications are typically options for tumors that can’t be surgically removed.

  [18]

• Targeted Therapies For people with GEP-NETs that affect the pancreas, the targeted drugs everolimus (Afinitor) and sunitinib (Sutent) have been shown to slow tumor growth and improve survival.

  [19]

• Targeted Radiation Drug Lutetium Lu 177 dotatate (Lutathera) binds to a specific molecule, called a somatostatin receptor, found on certain tumors; it then delivers a dose of radiation to the tumor. According to a review, people with GEP-NETs who were treated with Lutetium Lu 177 dotatate experienced an improvement in overall quality of life, which included metrics such as performing daily routines, engaging in leisure activities, and working. They also had improvements of symptoms such as diarrhea, fatigue, and abdominal pain.

  [20]

• Chemotherapy Chemotherapy uses drugs to kill cancer cells. It isn’t generally used for tumors that are grade 1 or 2, says Kim, but for the more aggressive grade 3 tumors. According to a study, more research needs to be done on chemotherapy’s effectiveness in grade 3 tumors, particularly new chemo combinations or chemotherapy combined with other treatments. Among the many chemo drugs used to treat GEP-NETs are streptozocin (Zanosar), doxorubicin (Adriamycin), etoposide (Vepesid), dacarbazine (DTIC-Dome), fluorouracil (Adrucil), and cisplatin (Platinol). Some of these drugs are given in combination.

  [21]

Supportive Care

• Stomach ulcers
• Diarrhea
• High or low blood sugar

Clinical Trials

Anyone with a GEP-NET might want to consider enrolling in a clinical trial. These studies give participants the opportunity to receive a novel medicine not currently available to the general public, which may also lead the way to improved treatments in the future.

You can search for a clinical trial on the National Cancer Institute’s website or by visiting ClinicalTrials.gov.