Treatment of Advanced Small Intestine Neuroendocrine Tumour with Somatostatin Receptor-Negative Lesions

This protocol addresses advanced small intestine carcinoid (Si-NET) in which tumour lesions are somatostatin receptor (SST) negative. Because SST expression is absent or insufficient, standard somatostatin analogue-based strategies are not applicable, and a different first-line approach is required.

Clinical Scenario

Advanced small intestine neuroendocrine tumour with somatostatin receptor-negative tumour lesions. The absence of SST expression means that other treatment strategies must be pursued, and this protocol defines the recommended first-line option when locoregional therapy is not appropriate.

First-Line Treatment Approach (partial)

When locoregional therapy is not an appropriate option in this setting, first-line systemic treatment — drawn from a specific class of agents with established evidence grades — can be considered.

The full regimen, recommended agent, dosing, and supporting evidence level are available in the complete protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jne.13423

In patients with advanced disease and SST negative lesions IFNα (RECOMMENDATION A-2b) or everolimus (RECOMMENDATION A-1b) can be used as first-line treatment if locoregional therapy is not an appropriate option.

Therefore, in patients with SST negative disease other treatment strategies are needed.

However, in patients with absent or insufficient SST expression without CS, everolimus is the treatment of choice in progressive G1/G2 Si-NET.

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