Table 4.

Neoadyuvant therapies in neuroendocrine tumors.

Tumor characteristics				Most appropriated treatment
Locally advanced pancreatic NET nonresectable due to vascular invasion	Ki-67 ≤10%	SSTR expression		Chemotherapy to achieve resectability RLT to achieve resectability
			Progression to first-line chemotherapy that sought resectability	SSAs upon progression if resectability is not considered RLT to achieve resectability
			FDG-PET positive (SUVm 5-7)	Chemotherapy to achieve resectability
Pancreatic NETs	Ki-67 ≤10%	SSTR expression	Resectable ‘borderline’ liver metastases	Locoregional therapy followed by surgery RLT followed by surgery if response Chemotherapy followed by surgery if response
Intestinal NETs	Ki-67 ≤10%	SSTR expression	Locally advanced, nonresectable due to vascular invasion	SSAs upon progression if resectability is not considered RLT to achieve resectability
			Resectable ‘borderline’ liver metastases	Locoregional therapy followed by surgery RLT followed by surgery if response
Colorectal NETs	Ki-67 ≤10%	SSTR expression	Resectable ‘borderline’ liver metastases	Locoregional therapy followed by surgery
Bronchial NETs	G1-G2	SSTR expression	Large-volume, localized, and probable pneumonectomy	Surgery

Abbreviations: NETs, neuroendocrine tumors; G, grade; SSTR, somatostatin receptor; RLT, radioligand therapy; FDG-PET, 2-fluoro-2-deoxy-d-glucose-positron-electron tomography; SSAs, somatostatin analogs; SUV, standardized uptake value.