Grade 3 well-differentiated neuroendocrine tumour: lines of therapy
5 standard-of-care settings across 3 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Screening, prevention and diagnosis
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis | Morphology, Ki-67 and p53 or Rb immunohistochemistry to separate grade 3 tumour from carcinoma; somatostatin receptor and FDG PET together. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | 89 |
Advanced, first line
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Advanced, somatostatin receptor-positive | Lutetium-177 dotatate first line for Ki-67 up to 55 percent (NETTER-2); somatostatin analogue alongside. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | 89 | |
| All comers | Advanced, shrinkage needed or receptor-negative | Capecitabine with temozolomide; everolimus or sunitinib for pancreatic tumours; platinum-etoposide for carcinoma-like tempo or Ki-67 near 55 percent. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | 91 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Trials | COMPOSE: 177Lu-edotreotide against CAPTEM, everolimus or FOLFOX in aggressive grade 2 and grade 3 gastroenteropancreatic tumours. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | 57 | |
| All comers | Limited disease | Resection and liver-directed therapy as for other well-differentiated tumours. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | 59 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.