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11 standard-of-care settings across 5 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
| Line | All comers | HR-positive |
|---|---|---|
| Screening, prevention and diagnosis | 1 | · |
| Early / localised | 2 | · |
| Advanced, first line | 3 | · |
| Second line | 1 | · |
| Other settings | 3 | 1 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Diagnosis and staging | Histology with Ki-67 grading; 68Ga/64Cu-DOTATATE PET/CT ± FDG PET; triple-phase CT or MRI of the liver; chromogranin A and syndrome-specific hormones; germline testing for pancreatic NETs and paragangliomas. | NCCN · Neuroendocrine and Adrenal Tumors | 94 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Localised | Resection. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | - | |
| All comers | Localised disease | Surgical resection (including primary tumour resection with liver metastases where feasible); endoscopic resection for small rectal/gastric NETs; surveillance for small incidental lesions. | NCCN · Category 2A | 40 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Advanced | SSA → 177Lu-DOTATATE → everolimus/cabozantinib/chemotherapy; alpha therapy in trials. | NCCN Guidelines: Neuroendocrine and Adrenal Tumors | 81 | |
| All comers | Advanced, grade 1-2, SSTR-positive, first line | Somatostatin analogue (octreotide LAR or lanreotide); 177Lu-DOTATATE first line for grade 2-3 (NETTER-2) with high burden. | NCCN · Category 1 (SSA); category 1 PRRT for grade… | 89 | |
| All comers | Advanced pancreatic NET needing tumour shrinkage | CAPTEM (E2211); PRRT; liver-directed therapy for hepatic-dominant disease. | NCCN · Category 2A | 73 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Advanced, progression on SSA | PRRT with 177Lu-DOTATATE (or 177Lu-edotreotide if approved); everolimus; sunitinib (pancreatic); cabozantinib (CABINET, all sites). | NCCN · Category 1 for PRRT and cabozantinib; 2A se… | 95 |
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Carcinoid syndrome | SSA dose escalation; telotristat ethyl for refractory diarrhoea; octreotide infusion peri-procedurally; echocardiographic screening for carcinoid heart disease. | NCCN · Category 2A | 81 | |
| All comers | After PRRT failure | Everolimus or cabozantinib; alpha PRRT in trials (ACTION-1, AlphaMedix); PRRT retreatment in selected patients. | NCCN · Trials preferred | 38 | |
| All comers | VHL-associated pancreatic NET | Belzutifan (approved 2021) for non-metastatic tumours not requiring immediate surgery. | NCCN · Category 2A | 92 | |
| HR-positive | Neuroendocrine carcinoma (poorly differentiated) | Platinum-etoposide (as in SCLC) ± PD-L1 inhibitor by extrapolation; FOLFIRINOX or CAPTEM in later lines; DLL3-directed agents in trials. | NCCN · Category 2A | 98 |
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.