Table 2.
Items regarding CS1: Patient with non-functioning enteropancreatic NET, non-susceptible to surgery or to loco-regional treatment, and with Ki-67 < 10 %, ECOG ≤2, NON-PROGRESSIVE in the last 3–6 months: Wait and see vs. SSA treatment? [11, 12, 16, 30, 32, 62]
| Previous rounda | Median (p25-p75) | Median range | Participants in median range n (%) | Result | |
|---|---|---|---|---|---|
| 1. Treatment is initiated with SSAs in most of this type of patients, since available evidence shows that even in patients with stable disease, treatment initiation significantly lengthens the time to progression. | 8 (8–9) | 7–9 | 58 (89.2) | C - A | |
| 2. In the absence of other risk factors (younger age [<60–65 years], important comorbidities or high Ki67), wait and see may be considered in patients with low tumor load (hepatic ≤25 %). | 30.8 %: 4–6 | 7 (4–8) | 7–9 | 38 (66.7) | C - A |
| 3. In the absence of other risk factors (high Ki67 or extra-hepatic disease), wait and see may be considered in fragile patients (with important comorbidities/elderly [>75 years]). | 8 (6–9) | 7–9 | 47 (72.3) | C - A | |
| 4. In the absence of other risk factors (younger age [<60–65 years], important comorbidities or extra-hepatic disease) wait and see may be considered in patients with low Ki-67 (<2 %). | 32.3 %: 4–6 | 7 (6–8) | 7–9 | 42 (73.7) | C - A |
| 5. Overall, wait and see is not considered in patients with Ki-67 > 5 %. | 8 (7–9) | 7–9 | 50 (76.9) | C - A | |
| 6. Tumor localization (pancreatic or non-pancreatic) is not a key criterion when deciding between wait and see or initiate treatment with SSAs. | 63.1 %: 7–9 | 8 (7–8) | 7–9 | 48 (84.2) | C - A |
| 7. Based on available evidence, lanreotide is the SSA of choice in the treatment of patients with NET of pancreatic origin and Ki67 > 2 % and <10 %. | 8 (7–9) | 7–9 | 54 (83.1) | C - A | |
| 8. Based on available evidence, octreotide is the SSA of choice in the treatment of patients with NET of pancreatic origin and Ki67 > 2 % and <10 %. | 40 %: 4–6 | 2 (2–3) | 1–3 | 45 (78.9) | C - D |
| 9. Based on available evidence, SSAs are the treatment of choice in patients with NET of digestive origin and Ki-67 < 2 %. | 8 (7–9) | 7–9 | 53 (81.5) | C - A |
CS Clinical situation, SSAs Somatostatin analogs, NET Neuroendocrine tumor, C consensus, NC non-consensus, A Agreement, D Disagreement
aOnly applies to statements with 2 rounds; participant % in median range: median range