Neuroendocrine tumors (NETs) are cancers that develop from hormone-producing cells called neuroendocrine cells. These cells are found throughout the body and link the nervous system with the hormone-producing endocrine system.
Targeted therapies are a category of anti-cancer drug that may be prescribed in the treatment of neuroendocrine tumors (NETs). Targeted therapies get their name because they are able to target specific features found on cancer cells. In other words, targeted therapies act on the features of cancer cells that make cancer cells different from healthy cells.
Different targeted therapy drugs work in different ways. Many are oral medications that work by blocking specific substances that cancers need to grow and spread, such as enzymes that activate cell growth and division or proteins that disrupt new blood vessel growth inside tumors. Compared to traditional chemotherapy, targeted therapy drugs like these typically cause less damage to healthy cells.
Some targeted therapies work by attaching to cancer cells to deliver other types of treatment (such as radiation) with greater precision.
Whenever you are prescribed a medication to treat cancer, it’s important to understand how that drug works and the goal of taking the drug.
When is a targeted therapy a good treatment option for NETs?
Treatment for NETs is different for everyone (and some of the key considerations are listed below). Surgery to remove the tumor or as much of the tumor as possible is usually the preferred first step in treatment, but not always possible. Medications called somatostatin analogues (SSAs) can counteract excess hormones caused by NETs and also help shrink NETs. Supportive therapies to control symptoms like excess stomach acid, diarrhea, and blood pressure may also be prescribed.
Because targeted therapies act on cancer cells throughout the body, these can be a treatment option for cancers that have spread. A targeted therapy may also be used if the cancer does not respond to treatment with SSAs. If a targeted therapy is prescribed it may be used in combination with chemotherapy, surgery, and/or other procedures to destroy tumors.
Again, treatment is individualized, and you should discuss your healthcare provider’s recommendations for treatment and the factors those recommendations are based on.
Factors that are considered when making treatment decisions:
- Location. Most NETs begin in the gastrointestinal (GI) tract. Others occur in the lungs and pancreas. NETs in other locations in the body can also occur but are rare.
- Size. Along with location, the size of the tumor is important, as it will be a key factor in determining if a tumor can be removed by surgery.
- Stage. In addition to tumor size, staging also considers whether the cancer has spread and where it has spread.
- Hormone production. Functioning NETs produce and release excess hormones into the body. Non-functioning NETs do not. Functional and non-functional NETs cause different symptoms that will need to be addressed with treatment.
- Tumor grade. Poorly-differentiated NET cells and tissues look more abnormal when examined with a microscope and are more likely to be aggressive. Well-differentiated NET cells look closer to normal cells and tissues, and tend to grow and spread more slowly.
- Symptoms. A healthcare team will consider whether the cancer is causing symptoms, what those symptoms are, and how severe the symptoms are.
- Overall health. A person’s age, overall health, medical history, and any coexisting conditions are important factors to consider when treating any cancer.
- Preferences. The preferences and concerns of the person being treated are also important factors to consider when treating any type of cancer.
Your healthcare providers may have additional considerations based on your diagnosis and your health. You may have additional questions and concerns—and if you do, you should bring them up with your healthcare team.
How to use this information
People with any type of cancer are encouraged to be an active participant in treatment decisions. The term for this is shared decision making. Patient education—learning about the type of cancer you have, including how it is treated—is an essential part of this process. When researching a condition, it helps to have a good understanding of the basics, including common terms you may come across when reading about NETs or talking to a healthcare team.
Also, keep learning about treatment for NETs. Research into NETs is an ongoing process, and treatment recommendations can change and evolve as new therapies become available.
Sources: Canadian Cancer Society. Drug therapy fo... + 17
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- American Cancer Society. How Targeted Therapies Are Used to Treat Cancer.
- National Cancer Institute. Targeted Therapy to Treat Cancer.
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- Mayo Clinic. Everolimus (oral route).
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- B. Mark Evers. Overview of Gastrointestinal and Pancreatic Neuroendocrine Tumors (NETs). Merck Manual Professional Version. May 2024.
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- American Cancer Society. Treating Pancreatic Neuroendocrine Tumor, Based on Extent of the Tumor.
- Mayo Clinic. Neuroendocrine tumors.
- B. Mark Evers. Overview of Gastrointestinal and Pancreatic Neuroendocrine Tumors. Merck Manual Consumer Version. May 2024.
- Neuroendocrine Tumor Research Foundation. Understanding Your Neuroendocrine Tumor Diagnosis.
- American Cancer Society. Understanding Your Options and Making Treatment Decisions.
