This protocol addresses the structured next step for patients with glucagonoma that is unresectable, locoregionally advanced, or has spread to distant sites — specifically when initial therapy has failed to control the disease or its associated symptoms.
The patient has glucagonoma that cannot be surgically removed, or that involves locoregional advanced disease and/or distant metastases. Curative-intent resection is not feasible, and ongoing management of disease progression is required.
Initial therapy with a somatostatin analogue (octreotide LAR or lanreotide) — combined where indicated with resection of metastases and primary tumor, and management of hyperglycemia and symptoms — did not achieve all of the following goals:
When the initial somatostatin analogue-based regimen no longer achieves disease control, structured protocols define subsequent systemic therapy options as well as locoregional interventions — with the approach guided by disease distribution, receptor status, and clinical context. The complete sequenced algorithm and options are available in the full protocol.