Clinical management of targeted therapies in neuroendocrine tumours

Targeted treatments such as sunitinib and everolimus are providing exciting new options for the management of pancreatic neuroendocrine tumours (pNETs). Clinical management of patients receiving targeted therapies aims to maximise the benefits patients achieve whilst minimising the impact of side effects to maintain quality of life. Adverse event management requires physicians to control co-morbidities, carefully review medication histories and to educate and support patients prior to receiving new treatments. Individual strategies to control specific common side effects such as fatigue, diarrhoea and stomatitis should be employed to allow optimal treatment duration and maintenance of dose intensity; all of which are key to ensure maximum benefit is derived from any treatment option. Recognising and acknowledging the difficulties patients may experience with adherence to chronic medications, and providing strategies to overcome them is a further important component of patient care. At the core of clinical management is effective communication between patients and physicians, which ensures patients are fully involved in decisions concerning their care, and will allow advances in the use of targeted therapies to be translated into benefits for individual patients.