Dr. Hope on Sequencing Considerations for GEP-NETs

Thomas Hope, MD, an associate professor of radiology at University of California, San Francisco (UCSF), discusses considerations when making sequencing decisions for patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs).

There is no answer to the optimal sequence of treatments for patients with GEP-NETs, because there are no data to support an order to the available treatments, explains Hope. The decision regarding what therapy to give a patient depends on their disease and comorbidities, including liver failure, renal failure, bone marrow injury, diabetes, infections, and more, according to Hope.

Additionally, the location of the disease impacts whether patients should receive liver-directed therapy or surgical resection. Hope suggests physicians consider the patient, extent of disease, type of tumor, aggressiveness of tumor, and tumor grade when deciding what therapy to administer.

The decision how to sequence therapy for each patient often falls to multidisciplinary tumor boards, says Hope. At UCSF, the tumor boards involve radiology, nuclear medicine, medical oncology, surgery, and pathology, concludes Hope.