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An update on the management of pancreatic neuroendocrine tumors

Gao, Limina; Natov, Nikola S.c; Daly, Kevin P.b; Masud, Faisald; Chaudhry, Sadiae; Sterling, Mark J.c; Saif, Muhammad W.a

doi: 10.1097/CAD.0000000000000633

Pancreatic neuroendocrine tumors (PNETs) are a rare and heterogeneous group of neoplasia and differ in their clinical presentation, behavior, and prognosis based on both histological features and cancer stage at the time of diagnosis. Although small-sized tumors can be surgically resected, locally advanced and metastatic tumors confer a poor prognosis. In addition, only limited treatment options are available to the latter group of patients with PNETs, such as hormonal analogs, cytotoxic agents, and targeted therapy. In selected patients, liver-directed therapies are also used. As expected, clinicians taking care of these patients are challenged to develop an effective and comprehensive treatment strategy for their patients amid a wide variety of treatment modalities. Targeted therapy for PNETs is limited to sunitinib and everolimus. Presently, a number of clinical studies are ongoing to assess the efficacy of newer targeted agents alone and in combination with previous agents for the treatment of advanced PNETs. The authors reviewed the current treatment and also discussed the emerging agents and emphasized the need to identify biomarkers.

aDivision of Hematology and Oncology, GI Oncology Program and Experimental Therapeutics

bDepartment of Radiology

cDivision of Gastroenterology, Tufts University School of Medicine, Boston, Massachusetts, USA

dKing Edward Medical University, Lahore

eFoundation University Medical College, Rawalpindi, Pakistan

Correspondence to Muhammad W. Saif, MBBS, MD, Department of Medicine and Cancer Center, Tufts Medical Center, 800 Washington Street Box 245, Boston, MA 02111, USA Tel: +1 617 636 5627; fax: +1 617 636 8535; e-mail:

Received January 23, 2018

Accepted March 23, 2018

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