©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Apr 10, 2016; 7(2): 149-154
Published online Apr 10, 2016. doi: 10.5306/wjco.v7.i2.149
Published online Apr 10, 2016. doi: 10.5306/wjco.v7.i2.149
Sequential treatment in disseminated well- and intermediate-differentiated pancreatic neuroendocrine tumors: Common sense or low rationale?
Enrique Grande, Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
Author contributions: Grande E wrote the article and approved the final wording and editing; no medical writer assistance was needed.
Conflict-of-interest statement: Grande E has served as advisor for GSK, Pfizer, and Lexicon and has delivered lectures for Pfizer, Novartis, IPSEN, and Lexicon.
Correspondence to: Enrique Grande, MD, Department of Medical Oncology, Ramón y Cajal University Hospital, Carretera de Colmenar Km 9, 1, 28034 Madrid, Spain. egrande@oncologiahrc.com
Telephone: +34-91-3368263
Received: June 14, 2015
Peer-review started: June 16, 2015
First decision: September 22, 2015
Revised: September 24, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: April 10, 2016
Processing time: 297 Days and 14.9 Hours
Peer-review started: June 16, 2015
First decision: September 22, 2015
Revised: September 24, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: April 10, 2016
Processing time: 297 Days and 14.9 Hours
Core Tip
Core tip: There is a need to improve the rationale we use when approaching to a sequential systemic treatment strategy in disseminated neuroendocrine tumors. Up to now, we do not have level 1 evidence to use any systemic alternative after failure to a prior one. Widely heterogeneous populations have been recruited in larger phase III pivotal trials in neuroendocrine tumors. Therefore, it is difficult to find final conclusions from the registration trials. In this article we aim to summarize the available evidence behind the use of different alternatives after failure to standard somatostatin analogs.