Optimizing the Treatment of Pancreatic Neuroendocrine Tumors

There are various treatment strategies currently available for the treatment of patients with pancreatic neuroendocrine tumors (pNETs). These approaches include chemotherapeutic and biologic agents, intraoperative and perioperative modalities, ablating instruments, and embolic therapies. Determining the appropriate sequence for these therapies is important for future advancements, states J. Phillip Boudreaux, MD. Advances in the clinical field have been made possible by collaboration and pooling data among researchers, says Rodney Pommier, MD.

Reevaluation and active surveillance are also important, adds Boudreaux, noting that his practice has evaluated patients whose tumors were initially deemed unresectable but were eventually rendered resectable. These patients underwent significant debulking of their tumors, improving their quality of life and overall survival.

Surgery will have a role in the management of pNETs, comments Diane Reidy-Lagunes, MD, but more data will reveal which populations will benefit the most. A lack of data means that the treatment decisions often have to be made based on clinical judgment rather than supported by robust clinical data, says Lagunes.

Discovering more effective predictive and prognostic markers will also be critical going forward, notes Pamela L. Kunz, MD.