Dr. Zhen on Advancements in Gastroenteropancreatic Neuroendocrine Tumors

David Zhen, MD, assistant professor, University of Washington School of Medicine, assistant professor, Clinical Research Division, Fred Hutchinson Cancer Research Center, physician, Seattle Cancer Care Alliance, discusses advancements in the treatment of patients with gastroenteropancreatic neuroendocrine tumors.

Treatments for this patient population have been limited, thus far, with somatostatin analogs, such as octreotide (Sandostatin) and lanreotide (Somatuline), as well as some chemotherapy agents serving as the foundation, according to Zhen. Advancements were made with the advent of peptide receptor radionuclide therapy with lutetium Lu 177 dotatate (177Lu-Dotatate; Lutathera), as well as sunitinib (Sutent), which has been FDA approved for the treatment of pancreatic neuroendocrine tumors, Zhen says. However, once patients progress on these therapies, there are very few other treatment options available, Zhen notes.

Recent data have shown that surufatinib demonstrated an improved progression-free survival vs placebo in previously treated patients with both extra-pancreatic and pancreatic neuroendocrine tumors, Zhen explains. The drug has been approved for use in China, and a new drug application was accepted by the FDA in July 2021, Zhen adds.

Furthermore, preliminary data from ongoing studies has suggested benefit with cabozantinib (Cabometyx) plus lenvatinib (Lenvima) for the treatment of this patient population, Zhen adds. The data with this combination have been impressive because they demonstrate efficacy, even if patients have already been exposed to other TKIs. The mechanism of action of these agents target pathways other than VEGF, and therefore can potentially overcome resistance, Zhen concludes.