September 19, 2021
Treating neuroendocrine cancer/tumour
SPECIALISED WEBSITES
INCA: International Neuroendocrine Cancer Alliance
This is a good summary: https://www.cancercenter.com/cancer-types/neuroendocrine-tumors/treatments
https://main.icmr.nic.in/sites/default/files/guidelines/Consensus_2.pdf
WHY INSUFFICIENT RESEARCH
“this orphan group of tumors which does not hold much interest to the pharmaceutical companies.” [Source]
BROAD TREATMENTS
Depending on the type of NET, medications that may be used include:
- Somatostatin analogs
- Chemotherapy
- Targeted therapy
- Immunotherapy
- Peptide receptor radionuclide therapy (PRRT) [Source]
Octreotide LAR
This is a form of somatostatin treatment: From somatostatin to octreotide LAR: evolution of a somatostatin analogue
“Octreotide is a potent synthetic somatostatin analogue that has become the mainstay of medical therapy for tumor control in neuroendocrine disorders. The multiple effects of octreotide throughout the body, combined with its established safety profile, make it an appealing and reliable option for clinicians. ”
“the antiproliferative effect of octreotide LAR in patients with well-differentiated metastatic GEP-NETs of the midgut” – but this is POORLY differentiated.
“Octreotide was among the first biotherapeutic agents used in the management of GEP-NETs and continues to be a mainstay of therapy today, although it is rarely curative”
“In response to results from the PROMID study, guidelines from the National Comprehensive Cancer Network (NCCN) have been updated to recommend octreotide LAR 20–30 mg as a management option in patients with recurrent or unresectable metastatic carcinoid tumors originating from any primary site of disease (small bowel, colon, rectum, appendix, lung, thymus, stomach) irrespective of functional status, symptomatology and progression status” [While there might be an origin in the colon/rectum, there is also a possible link with the prostate]
SIDE EFFECTS OF CHEMOTHERAPY