Treating GEP-NETs
The treatment you receive will depend on multiple factors, including1,2
Surgery
When planning treatment, surgery is usually one of the first options to help remove the tumor as a potential cure in the early stages of the cancer, or to reduce the tumor size and burden. In many cases the tumor can’t be removed completely, but surgery may help to reduce the size of the tumor and help to manage any symptoms.1
Due to the nature of GEP-NETs and delays in diagnosis, it’s common for the tumor to have spread to other parts of the body.3 In these cases, surgery may not always be possible due to the factors mentioned previously affecting the available treatment options. In metastatic cases, surgery is beneficial in helping manage the symptoms, size, and spread of the GEP-NET alongside other treatments, even if it doesn’t cure the disease.1,2 Your doctor and clinical team will discuss and recommend whether surgery is the right treatment option for you.
Medical therapy
Your doctor may also prescribe medical therapy to help slow the growth of the tumor and control any symptoms. There are many different types of medical therapy for the treatment of GEP-NETs, and most people will receive more than one of these therapies throughout their GEP-NET journey.1 Your doctor and clinical team will discuss and recommend the most clinically appropriate treatments that are right for you, based on the factors mentioned above.1
The table below summarizes the information available surrounding the most common treatment options. The treatments are listed in no particular order for how frequently they would be prescribed.
Type of medical therapy
How does it work?
Reduces the amount of hormones produced by the tumor, helping to control symptoms and slow tumor growth.4,5
When is it used?
It is common for people with GEP-NETs to be given SSA therapy as their first treatment.1
How is it administered?
Injection under the skin (subcutaneous) or into the muscle (intramuscular).4,5
A healthcare professional may administer your injections for you, or you may be able to self-administer at home.6
How does it work?
Help control symptoms and slow tumor growth. Tumor cells are damaged by a targeted dose of radiation from inside the tumor cells.1,7
Although radioligand therapy is designed to specifically target tumor cells, the radiation may travel to nearby healthy cells too.8
When is it used?
You may be given radioligand therapy after SSAs or other therapies stop working.1
To receive radioligand therapy, the tumor(s) must have somatostatin receptors.1
How is it administered?
Infusion into a vein (intravenous).1
How does it work?
Reduces blood supply to tumors, which helps to slow the growth and spread of the cancer.9
When is it used?
You may be given everolimus if your GEP-NET is not causing symptoms, and your SSAs or other therapies have stopped working.1
How is it administered?
Tablet to swallow.9
How does it work?
Blocks the action of molecules called receptor tyrosine kinases (TKIs),1 which contribute to the growth and spread of tumors.10 By blocking these molecules, they block the formation of new blood vessels which help the tumor to grow (antiangiogenesis).11,12
When is it used?
You may receive sunitinib if you have a neuroendocrine tumor (NET) in your pancreas.1
How is it administered?
Capsule to swallow.11
How does it work?
Chemotherapy drugs work on fast-growing parts of your body, including tumors, but also parts like hair and bone marrow.13,14
These drugs contain chemicals that damage cells as they grow and divide.13-15 This helps to slow the growth and spread of the cancer cells but can also affect rapidly-dividing healthy cells.13,14
The damage to healthy cells is usually repaired naturally after the course of chemotherapy.13
When is it used?
You may be given chemotherapy if your GEP-NET is fast-growing or has spread to other parts of the body, or if you have a NET in your pancreas.1
How is it administered?
It’s common for people to be given a combination of chemotherapy drugs for GEP-NETs.14
Depending on the type of chemotherapy you are prescribed, you may receive an infusion into a vein, or a capsule or tablet to swallow.15
How does it work?
Targeted injection of particles known as “microspheres” or mixtures of chemotherapy and blood clotting agents into the body. These work to block (embolize) the blood vessels which feed the tumor and help it to grow.16,17 Some particles can contain and deliver radiation directly to the tumor.17
When is it used?
This treatment is commonly used when you aren’t eligible for surgery and the tumor particularly affects the liver or your symptoms are uncontrolled.16
How is it administered?
Injected via a tube (catheter).16
How does it work?
Triggers the immune system to attack the cancer.18
When is it used?
You may receive IFN-α if the tumor lacks specific receptors called somatostatin receptors (SSTRs).1
How is it administered?
Injection under the skin (subcutaneous).18
A healthcare professional may administer your injections for you, or you may be able to self-administer at home.18
Discussing your treatment with your doctor and clinical team
When it comes to your treatment plan there can be a lot of information to process, so it’s important to talk to your doctor and the clinical team if you have any questions or concerns. If possible and you feel comfortable, we would suggest you don’t go to your consultations and medical appointments alone. We’ve included some points that you may find useful when discussing your treatment with your doctor and clinical team:
