Video

Case Study: Treating Metastatic Pancreatic NETs

For High-Definition, Click

Moderator, Matthew H. Kulke, MD, introduces are case-based discussion in which a patient presents with a kidney stone. Following a CT scan, the patient is incidentally found to have some spots in the liver and a mass in the tail of the pancreas. Following a biopsy, the patient was diagnosed with a well-differentiated neuroendocrine tumor (NET).

At this point, Rodney F. Pommier, MD, believes that it is important to determine whether the patient has a genetic syndrome, such as multiple endocrine neoplasia type 1, and also to investigate whether other family members might be affected. For this patient, a combination of major liver surgery and pancreatic surgery might be too much surgery in one setting for the patient, Pommier believes.

In a patient who has an unresectable asymptomatic pancreatic NET it is important to confirm that the somatostatin receptor positive status is present, notes Diane Reidy-Lagunes, MD, MS. Watchful waiting is a reasonable approach for a patient that truly is asymptomatic. However, in a patient with more advanced disease, a somatostatin analog might be appropriate. It is important to have these discussions with the patient, she added.

Jonathan R. Strosberg, MD, also believes the best options in this scenario are observation or treatment with a somatostatin analog. These approaches are the least risky and the least toxic. However, for patients with high volume symptomatic disease, cytotoxic chemotherapy may be appropriate, Strosberg believes.

Related Videos
Haley M. Hill, PA-C, discusses preliminary data for zenocutuzumab in NRG1 fusion–positive non–small cell lung cancer and pancreatic cancer.
Haley M. Hill, PA-C, discusses how physician assistants aid in treatment planning for NRG1-positive non–small cell lung cancer and pancreatic cancer.
Haley M. Hill, PA-C, discusses DNA vs RNA sequencing for genetic testing in non–small cell lung cancer and pancreatic cancer.
Haley M. Hill, PA-C, discusses current approaches and treatment challenges in NRG1-positive non–small cell lung cancer and pancreatic cancer.
Tanios Bekaii-Saab, MD, FACP
Cindy Medina Pabon, MD, assistant professor, Sylvester Cancer Center, University of Miami; assistant lead, GI Cancer Clinical Research, Gastrointestinal Medical Oncology, University of Miami Health Systems
Mohammed Najeeb Al Hallak, MD, MS, and Sakti Chakrabarti, MD, discuss ongoing research in gastrointestinal cancers.
Mohammed Najeeb Al Hallak, MD, MS, and Sakti Chakrabarti, MD, discuss research building upon approved combinations in unresectable hepatocellular carcinoma.
Mohammed Najeeb Al Hallak, MD, MS, and Sakti Chakrabarti, MD, on trastuzumab deruxtecan–based regimens in advanced HER2-positive GI cancers.
Mohammed Najeeb Al Hallak, MD, MS, and Sakti Chakrabarti, MD, on tremelimumab/durvalumab vs atezolizumab/bevacizumab in unresectable HCC.