Metastatic Gastro-intestinal Neuroendocrine Tumors: A Case Report of Real Life Management Challenges and Success

Introduction: Until recently, there have been limited options for treatment of metastatic neuro endocrine tumors (NETs). Real life experience with newly developed targeted therapies for this condition is limited outside large referral centers. Case: Here we describe a 43 year old patient with metastatic NET of intestinal origin. The management of this patient illustrates a number of real life practical issues including effect of treatment interruption, secondary resistance to somatostatin analogues, availability and toxicity of new targeted agents, multiple lines of sequential treatment and local availability of specific investigations. This patient is enjoying a long progression free survival (29+ months) on a combination of Everolimus and Octreotide-LAR with a survival of 43+ months from diagnosis of metastatic disease. Conclusion: Patient with metastatic NETs can benefit from newly developed targeted therapies. However, they are best managed by multi-disciplinary teams in referral centers to guarantee adequate experience and specialist resources.