The North American Neuroendocrine Tumor Society Consensus Guidelines for Surveillance and Medical Management of Pancreatic Neuroendocrine Tumors

Abstract

This article is the result of the North American Neuroendocrine Tumor Society consensus conference on the medical management of pancreatic neuroendocrine tumors from July 19 to 20, 2018. The guidelines panel consisted of medical oncologists, pathologists, gastroenterologists, endocrinologists, and radiologists. The panel reviewed a series of questions regarding the medical management of patients with pancreatic neuroendocrine tumors as well as questions regarding surveillance after resection. The available literature was reviewed for each of the question and panel members voted on controversial topics, and the recommendations were included in a document circulated to all panel members for a final approval.

Mutational landscape and potential therapeutic targets for sporadic pancreatic neuroendocrine tumors based on target next‑generation sequencing

“…The percentage of Ki-67 nuclear staining (Ki-67 index; Fig. S1C-F) (13) was used to determine the grade of PNET (14). The histological diagnosis of tumors was performed and confirmed by two pathologists.…”

It's not a mystery, it's in the history: Multidisciplinary management of multiple endocrine neoplasia type 1

“…Others have shown that resection of duodenal gastrinomas, regardless of symptoms, prolongs survival. 36,37 In our patient, given the pNET size and absence of a clinical syndrome, we decided to proceed with active surveillance.…”

“…FIGURE 4. Framework for Initial Management and Surveillance of the Patient With Multiple Endocrine Neoplasia Type 1 (MEN1) 1,10,11,15,32,36,65. (A) General flowchart, (B) parathyroid gland management, (C) duodenopancreatic neuroendocrine tumor (dpNET) management, and (D) pituitary adenoma (PA) management are illustrated.…”

Treatment of advanced gastro-entero-pancreatic neuro-endocrine tumors: A systematic review and network meta-analysis of phase III randomized controlled trials

“…Several new therapies have been approved to treat well-differentiated advanced gastroentero-pancreatic neuroendocrine neoplasms (GEP-NENs) in the last twenty years [1]. European Neuro-Endocrine Tumor Society (ENETS) and North American Neuro-Endocrine Tumor Society (NANETS) guidelines [2][3][4] recommend somatostatin analogs (SSAs) alone as first-line therapy. Interferon-α, tyrosine kinase inhibitors (Everolimus and Sunitinib), or peptide receptor radionuclide therapies (PRRT) are considered only in patients with progressive diseases as a second or further line of treatment.…”