Neuroendocrine tumors have a variety of treatments available. From surgical, radiologic and medical management, there are a number of treatment options. No two patients are exactly alike and throughout the course of the disease, all options should be considered. Here is a brief overview of treatment modalities.
Surgery is always the number one treatment of all neuroendocrine tumors including carcinoid if the patient is a surgical candidate. It usually involves removing as many tumors, including the primary, if possible. Frequently, these tumors are microscopic, so most treatment is considered a debulking treatment. Surgeries can be both traditional “invasive” open-surgical techniques as well as through interventional radiology with treatments such as ablation, and embolizations such as bland, radio and chemo. Read more about the different types of treatments available from John Hopkins.
Octreotide is a synthetic version of somatostatin, which helps NET patients with symptom control. It inhibits the secretion of many hormones, such as, such as gastrin, cholecystokinin, glucagon, growth hormone, insulin, secretin, pancreatic polypeptide, TSH, and vasoactive intestinal peptide. It is short acting and therefore multiple shots are needed if symptoms are persistent. Many people use octreotide in tandem with pump designed for insulin delivery to provide a steady rate of octreotide delivery.
Sandostatin (nicknamed Sando by patients) is a long acting somatostatin analogue prescribed to many NET patients for symptom control.
Lanreotide (Somatuline Depot)
Lanreotide is a synthetic analogue of somatostatin, a naturally occurring inhibitory hormone which blocks the release of several other hormones, including growth hormone, thyroid-stimulating hormone (TSH), insulin and glucagon. Lanreotide binds to the same receptors as somatostatin, although with higher affinity to peripheral receptors, and has similar activity. However, while somatostatin is quickly broken down in the body (within minutes), lanreotide has a much longer half-life, and produces far more prolonged effects. Read the results from the Clarinet study. Lanreotide is injected every ten to fourteen days intermuscularly. Somatuline Depot (lanreotide) Injection 60, 90 and 120 mg is a prolonged-release formulation for deep subcutaneous injection containing the drug substance lanreotide acetate, a synthetic octapeptide with a biological activity similar to naturally occurring somatostatin. This drug is administered once a month and is done subcutaneously.
Somatuline Depot is the brand name for lanreotide. Injection 60, 90 and 120 mg is a prolonged-release formulation for deep subcutaneous injection containing the drug substance lanreotide acetate, a synthetic octapeptide with a biological activity similar to naturally occurring somatostatin. This drug is administered once a month and is done subcutaneously.
Telotristat ethyl (Xermelo)
This drug that was approved for treatment of carcinoid syndrome diarrhea that is not controlled by somatostatin analogues such as Sandostatin LAR or Lanreotide (Somatuline Depot).
The brand name for Everolimus, a form of chemotherapy prescribed to pancreatic NETs that was approved by the FDA in 2011.
The brand name for Sunitinib, a form of chemotherapy prescribed to pancreatic NETs that was approved by the FDA in 2011.
A combination of two chemos, capecitabine and temozolomide, the results of this drug have been effective for many advanced neuroendocrine cancer patientsoffers long-lasting neuroendocrine tumor control for patients whose tumors have not responded to standard high-dose octreotide therapy.
This site is maintained by the National Institutes of Health and details all current and continuing clinical trials in the U.S. and around the world.
NON-SURGICAL OPTIONS ON THE HORIZON
Only available in Europe at this time, although in clinical studies in the U.S., Peptide Receptor Radionuclide Therapy is one form of treatment that has been a successful treatment for many patients. It is a form of targetted molecular therapy that combines octreotide with a radio isotope that is administered as a systemic treatment for neuroendocrine tumors known as GEP-NETs. GEP-NETs are gastroenteropancreatic tumors that start in small intestines, the pancreas, duodenum or stomach, large intestives, lung and other diffuse tissues including the adrenal, thymus, and pituitary glands. Visit the Society of Nuclear Medicine and Imaging site for more information on PRRT.
- Be sure to check out our page of patient stories who have undergone PRRT treatment both in the U.S. as clinical trials and abroad.
- Here is a list of centers from around the world that are currently offering this treatment. Many of them have been offering it for over 20 years, so they have expertise that will take time to develop in the U.S.endocrine tumors and treatment.