Pancreatic NETs Diagnosis and Treatment Challenges

Pancreatic neuroendocrine tumors (pNETs) are rare tumors that tend to be more aggressive than other types of NETs. Additionally, these tumors are commonly not diagnosed until after the disease has metastasized, states James C. Yao, MD. Occasionally, pNETs grow slowly and remain indolent, which often leads to them remaining undetected under a later stage, agrees Matthew H. Kulke, MD. Some tumors cause hormone hypersecretion, which may not be recognized until the tumors are fairly advanced.

With the approval of everolimus and sunitinib for the treatment of pNETs, there have been advances but additional lines of therapy are still needed, says Yao. More knowledge is needed regarding sequencing of therapies, adds Yao. One ongoing European study comparing streptozocin-based chemotherapy followed by everolimus, with the reverse sequence, will help answer an important question, he notes.