Oncology Brothers: Practice-Changing Cancer Discussions How to Diagnose, Treat, and Follow Neuroendocrine Tumors (NETs)
Nov 14, 2024
Dr. Pamela Kunz, a leading medical oncologist from the Yale Cancer Center, dives into the complex world of neuroendocrine tumors (NETs). She highlights the significance of the KI-67 marker in tumor classification and the role of advanced imaging like Gallium PET-CT. The discussion covers treatment strategies for both localized and metastatic cases, explaining the use of somatostatin analogs and newer therapies like lutetium dotatate. Insights into next-generation sequencing and the evolving treatment landscape make this a must-listen for oncology enthusiasts.
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NET Classification Essentials
- Neuroendocrine tumors (NETs) are classified by primary site, grade, differentiation, and stage, with KI-67 index defining grade 1 to 3.
- Well-differentiated NETs are grade 1 to 3, while poorly differentiated are termed neuroendocrine carcinomas with generally higher KI-67.
Tailoring NET Treatment Decisions
- Surgery is recommended for localized NETs barring comorbidities, often without need for further treatment.
- For metastatic NETs, treatment depends on symptoms, tumor bulk, and shrinkage goals, with options limited for tumor shrinkage.
Optimizing Somatostatin Analog Use
- Start somatostatin analogs without test doses, using short-acting forms only if immediate symptom relief is needed.
- Lanreotide and octreotide have similar tumor control efficacy; choose based on administration preference.