Treatment

Conditions treated:

  • Pancreatic NETs
  • Well-differentiated tumors of the GI tract (stomach, small intestine, appendix, colon and rectum), kidney, ovaries and presacral space, as well as unknown primary NETs
  • Bronchial carcinoid
  • Thymic carcinoid
  • Small cell lung carcinoma
  • large cell NEC of lung
  • Other poorly differentiated NECs (small and large cell NECs)
  • Well differentiated G3 NETs
  • Neuroendocrine prostate cancer (NEPC)
  • Merkel cell carcinoma
  • Paraganglioma/Pheochromocytoma
  • Adrenal Cortical Carcinoma
  • Medullary Thyroid Carcinoma
  • Mixed tumors (adenoneuroendocrine carcinomas, mixed acinar-neuroendocrine tumors, globlet cell carcinoid)

Types of therapeutic interventions

  • PRRT (Peptide receptor radiotherapy)   Peptide refers to a small molecule that is very similar to the naturally occurring hormone somatostatin.   read more
  • Surgery  At UCSF, we have extensive experience evaluating patients and performing complex operations for neuroendocrine tumors.  read more
  • Liver-directed therapy
  • Somatostatin analogs
  • Oral targeted agents (e.g. everolimus, sunitinib, telotristat)
  • Chemotherapy
  • Other types of radiation therapy

 

Well-differentiated (having cells most like the surrounding tissue) metastatic tumors are treated with a range of interventions including: liver resection, other liver-directed therapy such as selective internal radiation therapy (SIRT) and hepatic artery chemo embolization (HACE), somatostatin analogs such as octreotide, biologically targeted agents and/or chemotherapy.

 

Peptide receptor radionuclide therapy (PRRT), a therapy in which radioactive material is combined with a cell-targeting protein and delivered directly to the tumor, is also effective. This therapy was first offered in Europe and now offered at UCSF via clinical trial. It is expected that this will be approved by the FDA and available as standard of care treatment in the near future.

High grade NECs are typically treated with chemotherapy according to the guidelines for small cell lung cancer, the most common type of high grade NEC.