Dr. Paulson Discusses the Current Treatment for NETs

Scott Paulson, MD, co-director of the Gastrointestinal Research Program for The US Oncology Network, medical director for the Neuroendocrine Research and Treatment Center at Baylor Charles A. Sammons Cancer Center, Baylor University Medical Center, discusses the current treatment of patients with neuroendocrine tumors (NETs).

Everolimus (Afinitor) was approved in 2016 for the treatment of adult patients with progressive, well-differentiated non-functional, locally advanced or metastatic gastrointestinal or lung NETs. This approval was based on the findings of the RADIANT-4 trial, in which the median progression-free survival for everolimus was 11 months versus 3.9 months for placebo. Recently, a collaborative group effort showed the efficacy of capecitabine and temozolomide, which Paulson says confirmed what people have known for a while—chemotherapy is active in this disease. Additionally, sunitinib (Sutent) has been used in pancreatic NETs for many years, Paulson says.

Radiopharmaceuticals is one of the most exciting areas in the NET landscape. Lutathera (lutetium Lu 177 dotatate) was approved for the treatment of patients with somatostatin receptor—positive gastroenteropancreatic NETs by the FDA in January 2018. Telotristat ethyl (Xermelo) has also received approval for management in patients with carcinoid syndrome, Paulson notes.