Practical management of toxicities associated with targeted therapies for advanced gastroenteropancreatic neuroendocrine tumors

Authors Pieter-Jan Cuyle, Hans Prenen.


Neuroendocrine tumors are heterogeneous, rare malignancies that arise most frequently in the gastroenteropancreatic tract (GEPNET). The therapeutic armamentarium for the treatment of GEPNETs has expanded significantly over the last two decades, however the ideal sequencing strategy remains controversial. As this disease may be relatively slow-growing, patients are expected to be treated for longer periods, so that even mild toxicities can influence quality of life, compliance and outcome in the long run. Prospective data on optimal adverse event management are lacking and recommendations are largely based on expert opinion and drug prescribing information. This review summarizes practical recommendations for toxicity management associated with the most commonly used GEPNET treatment options and stresses important focus points for future clinical trials.

Keywords Neuroendocrine tumor, somatostatin analogue, peptide receptor radionucleotide therapy, interferon-α, everolimus, sunitinib, toxicity management

Ann Gastroenterol 2018; 31 (2): 140-150

Invited Reviews