Treatment of Advanced and Metastatic Somatostatinoma
Somatostatinoma is a rare neuroendocrine tumor. When disease is advanced or metastatic, systemic treatment becomes the primary management focus, with the approach encompassing both symptom-directed and antitumor strategies.
Treatment Approach
The evidence base for advanced somatostatinoma includes agents that target symptom burden as well as those with direct antitumor activity. Multiple drug classes and modalities are represented — the complete structured regimen specifies which options apply, under what circumstances, and how they are sequenced.
References
- Somatostatin analogues may be effective in reducing the symptoms of functional tumors.
- Chemotherapy using drugs such as the following, either alone or in combination, has been shown to have antitumor effects, but evidence is weak or conflicting regarding the impact of chemotherapy on overall survival.
- A variety of systemic agents have shown biological or palliative activity.
- Favorable responses have been reported in patients with advanced progressive pancreatic NETs after treatment with several radiolabeled somatostatin analogues in which the analogues octreotide, octreotate, lanreotide, or edotreotide are stably attached to the radionuclides indium In 111, yttrium Y 90, or lutetium Lu 177.