Indian Council of Medical Research Consensus Document for the Management of Gastroenteropancreatic Neuroendocrine Neoplasms

This consensus document may be used as a framework for more focused and planned research programs to carry forward the process. The aim of the Indian Council of Medical Research Guidelines is to assist oncologists in making major clinical decisions encountered while managing their patients while realizing the fact that some patients may require treatment strategies other than those suggested in these guidelines.

• The histological confirmation which includes the measurement of the proliferative index (Ki67) is mandatory prior to the commencement of definitive treatment

• All patients should be staged according to the TNM staging system, and risk should be assessed at diagnosis. A baseline contrast-enhanced computed tomography scan of the chest, abdomen, and pelvis should be considered

• Selected cases should be referred to genetic clinics (MEN syndrome)

• Patients should receive multidisciplinary care under the care of a surgical, medical, radiation oncologist, and nuclear medicine specialist

• Primary surgery remains the standard of care for all nonmetastatic tumors. Patients with advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) should be assessed on an individual basis to determine whether chemotherapy, targeted therapy, PRRT, or best supportive care should be provided

• Preferred regimens for chemotherapy include – capecitabine-temozolomide, cisplatin-etoposide and for targeted therapy – everolimus and sunitinib

• Patients should be offered regular surveillance after completion of curative resection or treatment of advanced disease

• Encourage participation in institutional and ethical review board-approved, registered controlled clinical trials

• Refer for early palliative care, if indicated.

Publication History

Received: 04 August 2019

Accepted: 24 October 2019

Article published online:
23 May 2021

• References

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