Advances in the Treatment of Pancreatic Neuroendocrine Tumors (pNETs).

Recent clinical trials have led to significant advancements in treatment options for metastatic neuroendocrine tumors of the pancreas. Sunitinib and everolimus have been approved by the Food and Drug Administration for treatment of progressive pancreatic NETs based on phase III trial data demonstrating improvements in progression-free survival. Cytotoxic drugs such as temozolomide and capecitabine have been associated with high radiographic response rates; however data derives primarily from subset analysis of prospective trials and from retrospective series. During the next few years, randomized clinical trials are expected to provide more clarity on the role of somatostatin analogs and cytotoxic drugs. New studies are also evaluating biomarkers that will potentially allow for improved selection of drugs for specific tumor subtypes.