Dr. Rajdev on the Use of Somatostatin Analogs in Neuroendocrine Tumors

Lakshmi N. Rajdev, MD, an associate professor, Department of Medicine (Oncology), at Albert Einstein College of Medicine, Montefiore Medical Center, discusses the use of somatostatin analogs in patients with neuroendocrine tumors (NETs).

Somatostatin analogs have been shown to improve progression-free survival in patients with low-grade NETs. However, there is some debate as to the optimal timing to introduce these agents, says Rajdev.

Patients with indolent disease could be monitored for extended periods of time without requiring treatment. If patients develop progressive or symptomatic disease, they could receive somatostatin analogs. Conversely, patients with a higher burden of disease could benefit from receiving these agents up front.

Another area of debate is whether to continue somatostatin analogs when patients have disease progression. In the absence of robust data, discontinuing the drug in patients with progressive disease is advisable, says Rajdev. Notably, switching to another analog has not been shown to be beneficial in this setting. Conversely, if patients have hormone secretion or carcinoid syndrome, they can continue on these analogs since they’ve shown activity in carcinoid syndrome and hormonal syndrome management, concludes Rajdev.