Carcinoid of small intestine
ICD-10 D37.2 · ICD-11 2B80.21

Treatment of carcinoid of small intestine in advanced intestinal neuroendocrine tumour grade 2 with Ki-67 above 10%, rapid progression and/or high tumour burden

Clinical Scenario

Advanced intestinal neuroendocrine tumour (NET) grade 2 with Ki-67 above 10%, with documented rapid progression and/or high tumour burden.

In this specific sub-population, standard approaches carry less certainty. When the proliferation index exceeds 10% and rapid progression or a significant tumour burden is present, more intensive first-line systemic treatment is considered for selected patients.

First-Line Treatment Approach

More intensive systemic treatment options exist for selected patients in this setting, spanning targeted therapy, radionuclide-based approaches, and systemic chemotherapy regimens. The specific choice depends on individual patient factors and eligibility criteria detailed in the full protocol.

Full regimen options, selection criteria, and sequencing are available in the structured evidence-based protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jne.13423

In patients with advanced intestinal NET G2 with Ki-67 >10% everolimus (RECOMMENDATION A-1b) and PRRT (RECOMMENDATION A-1b) are treatment options for selected patients.

The role of SSA in patients with NET G2 and proliferation rate above 10% is less clear, especially if a rapid progression is documented or if a high tumour burden is present.

Options of first-line systemic treatment in this setting may include everolimus, PRRT or systemic chemotherapy.

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