Dr. Choti on Challenging Treatment Decisions in NETs

Michael A. Choti, MD, chief of surgery, Banner MD Anderson Cancer Center, discusses challenging treatment decisions in patients with neuroendocrine tumors (NETs).

During the 6th Annual School of Gastrointestinal Oncology^® virtual interactive conference, Choti moderated a Medical Crossfire^® on the multidisciplinary management of NETs. For patients with metastatic NETs, tumor grade and the degree of differentiation should inform the need for chemotherapy, hormonal therapy, or radiation therapy, says Choti. However, determining grade, tumor aggressiveness, and differentiation is variable and largely dependent on Ki-67 expression, says Choti.

Additionally, questions remain regarding how aggressively metastatic NETs should be surgically resected, Choti explains. Some recommend that patients should undergo aggressive surgical resection irrespective of whether the entire burden of disease can be removed. In the early-stage setting, newly diagnosed patients with a small disease burden in the pancreas, for example, may benefit more from active surveillance vs surgery because they could have indolent disease, concludes Choti.