CONTACT A REP
Patients HCP
This site is for US Health Care Professionals only.
About GEP-NET Patients

Disease Progression

Proactively monitoring for progression is an important component of GEP-NET management, regardless of recurrent or worsening symptoms1-4

Potential methods of identifying and monitoring disease progression

Monitoring potential recurrent or increased symptoms due to functional carcinoid tumors5,6 

Potential symptoms due to functional carcinoid tumors include flushing, diarrhea, abdominal pain, wheezing, and palpitations

Monitoring potential recurrent or increased symptoms due to recurrence5,7

Potential symptoms due to recurrence include fatigue, dyspnea, and pain

These symptoms may also be seen at the initial presentation. This is not a comprehensive list and is provided only as a general recommendation.

Investigating indications of possible disease progression through biomarker identification8

Investigating indications of possible disease progression through biomarker identification, including chromogranin A and 5-hydroxyindoleacetic acid.

Measuring of tumor size and detecting new lesions through radiological evaluation2,9,10

Measuring tumor size and detecting new lesions through radiological evaluation, including a CT scan, MRI scan, and SSTR imaging.

Close monitoring can help you identify the appropriate time to consider different treatment options for patients who are progressing.2

Proactively Monitoring for Disease Progression, Regardless of Recurrent or Worsening Symptoms1-4

Symptoms associated with NETs may be nonspecific or absent until more advanced stages of disease. Disease progression may not be correlated with symptoms, so proactive monitoring may determine the right time for a change of treatment.
5-HIAA, 5-hydroxyindoleacetic acid; CgA, chromogranin A; CT, computed tomography; GEP-NETs, gastroenteropancreatic neuroendocrine tumors; MRI, magnetic resonance imaging; NETs, neuroendocrine tumors; SSTR, somatostatin receptor.
References: 1. Wolin EM, Leyden J, Goldstein G, Kolarova T, Hollander R, Warner RRP. Patient-reported experience of diagnosis, management, and burden of neuroendocrine tumors: results from a large patient survey in the United States. Pancreas. 2017;46(5):639-647. 2. Merino-Casabiel X, Aller J, Arbizu J, et al. Consensus document on the progression and treatment response criteria in gastroenteropancreatic neuroendocrine tumors. Clin Transl Oncol. 2018;20(12):1522-1528. 3. Sackstein PE, O’Neil DS, Neugut AI, Chabot J, Fojo T. Epidemiologic trends in neuroendocrine tumors: an examination of incidence rates and survival of specific patient subgroups over the past 20 years. Semin Oncol. 2018;45(4):249-258. 4. Ter-Minassian M, Zhang S, Brooks NV, et al. Association between tumor progression endpoints and overall survival in patients with advanced neuroendocrine tumors. Oncologist. 2017;22(2):165-172. 5. de Mestier L, Dromain C, d'Assignies G, et al. Evaluating digestive neuroendocrine tumor progression and therapeutic responses in the era of targeted therapies: state of the art. Endocr Relat Cancer. 2014;21(3):R105-R120. 6. Toumpanakis C, Garland J, Marelli L, et al. Long-term results of patients with malignant carcinoid syndrome receiving octreotide LAR. Aliment Pharmacol Ther. 2009;30(7):733-740. 7. American Cancer Society. Signs and symptoms of pancreatic neuroendocrine tumor. Updated October 30, 2018. Accessed July 22, 2024. https://www.cancer.org/cancer/types/pancreatic-neuroendocrine-tumor/detection-diagnosis-staging/signs-and-symptoms.html 8. Vinik AI, Woltering EA, Warner RRP, et al. NANETS consensus guidelines for the diagnosis of neuroendocrine tumor. Pancreas. 2010;39(6):713-734. 9. Panzuto F, Falconi M, Nasoni S, et al. Staging of digestive endocrine tumours using helical computed tomography and somatostatin receptor scintigraphy. Ann Oncol. 2003;14(4):586-591. 10. Dromain C, de Baere T, Lumbroso J, et al. Detection of liver metastases from endocrine tumors: a prospective comparison of somatostatin receptor scintigraphy, computed tomography, and magnetic resonance imaging. J Clin Oncol. 2005;23(1):70-78.