Paul R. Helft, MD, professor of medicine, Indiana University School of Medicine, Indiana University Health Melvin and Bren Simon Cancer Center, discusses pancreatic and carcinoid neuroendocrine tumors (NETs).

Both carcinoid and pancreatic NETs present various challenges, Helft says. About 20% to 40% of carcinoid tumors of the small intestine make hormones, the most common of which is serotonin, which causes carcinoid syndrome. That can bother patients with a number of gastrointestinal symptoms.

Pancreatic NETs are relatively rare and unique, but are often lumped in with carcinoid tumors of the stomach. These NETs make hormones in excess, which can lead to very significant syndromes. For example, pancreatic NETs that produce insulin in excess are very difficult to manage, says Helft, because they cause hypoglycemia.

Videos

Paul R. Helft, MD, professor of medicine, Indiana University School of Medicine, Indiana University Health Melvin and Bren Simon Cancer Center, discusses pancreatic and carcinoid neuroendocrine tumors.
 

Dr. Helft Discusses Pancreatic and Carcinoid NETs

Paul R. Helft, MD, professor of medicine, Indiana University School of Medicine, Indiana University Health Melvin and Bren Simon Cancer Center, discusses the use of capecitabine and temozolomide across gastrointestinal (GI) neuroendocrine tumors.

The regimen came about from a group at NYU Langone Health on the basis of preclinical data. The data suggested that the combination of capecitabine and temozolomide had an important cell-directed cycle effect on tumor cells. A couple of small studies of several dozen patients suggested significant activity in its use, Helft says.

Although its efficacy has been proven, it is a difficult regimen for patients to take because they have to take 1 of the drugs 2 out of the 4 weeks and the other drug every 10 to 14 days. However, it’s well tolerated and has activity that extends to pancreatic and other GI neuroendocrine tumors as well.

Paul R. Helft, MD

Articles

Dr. Helft Discusses Pancreatic and Carcinoid NETs

Dr. Helft on the CAPTEM Regimen in Patients With Neuroendocrine Tumors