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THERAPEUTIC ALGORITHM FOR panNETS

SOMATOSTATIN ANALOGUES:

• Functioning & non-functioning

• Octreoscan +ive

• Stable disease (progressive?)

Ki up to 10%

Not too much liver involvement

1

st

Treatment option

SUNITINIB / EVEROLIMUS / CHT

• Progressive disease

• Higher tumor burden

• Symptoms related with tumor

burden

2

nd

Treatment option

1

st

Treatment option

SUNITINIB / EVEROLIMUS / CHT / PRRT

• Sequential therapies