From the Guidelines
The patient is likely being planned for Transarterial Chemoembolization (TACE) or other transarterial therapies, such as TAE, DEB-TACE, or TARE, for the management of multifocal metastatic neuroendocrine tumor to the liver. These procedures are considered comparable alternatives for managing liver-dominant metastatic neuroendocrine tumors, as stated in the 2022 update of the ACR Appropriateness Criteria for management of liver cancer 1. TACE is a minimally invasive procedure that delivers high doses of chemotherapy directly to liver tumors while blocking their blood supply. During the procedure, a catheter is inserted through an artery in the groin and guided to the hepatic artery supplying the tumor. Chemotherapy drugs (often doxorubicin, cisplatin, or mitomycin C) mixed with embolic agents are then injected to both kill cancer cells and cut off blood flow to the tumor. Some key points to consider for the patient include:
- The procedure is particularly effective for neuroendocrine tumor liver metastases because these tumors are typically highly vascular and receive most of their blood supply from the hepatic artery.
- TACE is generally used when surgical removal isn't possible but the disease is confined to the liver.
- Patients should expect to stay in the hospital for 1-2 days after the procedure and may experience post-embolization syndrome (fever, pain, nausea) for several days.
- Multiple sessions may be required for optimal tumor control, as transarterial therapies have shown efficacy for overall survival, tumor growth reduction, and symptom control 1.
From the Research
Treatment Plan for Neuroendocrine Tumor with Liver Metastasis
The patient's treatment plan includes a procedure scheduled for next week, but the specifics of the procedure are not provided. However, based on the patient's condition, which includes a neuroendocrine tumor with liver metastasis, the treatment plan may involve the use of somatostatin analogs.
Somatostatin Analogs in Neuroendocrine Tumor Treatment
- Somatostatin analogs, such as octreotide and lanreotide, are commonly used in the treatment of neuroendocrine tumors (NETs) 2, 3.
- These analogs have been shown to have both antisecretory and antiproliferative effects, making them effective in managing hormone-related symptoms and controlling tumor growth 2, 4.
- Long-acting somatostatin analogs, such as octreotide LAR and lanreotide, have been developed to improve patient outcomes and reduce the frequency of administration 3.
Efficacy of Somatostatin Analogs in Advanced NETs
- Studies have demonstrated the efficacy of somatostatin analogs in advanced NETs, including those with liver metastasis 5.
- The use of somatostatin analogs has been shown to improve progression-free survival and overall survival in patients with well-differentiated NETs 2, 5.
- However, the efficacy of somatostatin analogs may vary depending on the tumor grade and hepatic tumor load 5.