Appropriateness of systemic treatments in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors

Table 6 First-Line treatment in patients with unresectable metastatic well-differentiated pancreatic neuroendocrine tumors

Rate the appropriateness of the following initial treatment options		In a patient whose primary problem is:
		Uncontrolled secretory symptoms	Uncontrolled tumor-related symptoms	No symptoms
No systemic therapy	Following optimal cytoreductive surgery	1.01 (0.0)	1.01 (0.0)	8.53 (1.5)
Somatostatin analogue		9.03 (0.0)	7.03 (1.1)	5.02 (0.7)
Everolimus		7.03 (0.5)	7.03 (0.9)	1.01 (0.4)
Sunitinib		7.03 (0.7)	7.03 (0.9)	1.01 (0.3)
Cytotoxic chemotherapy		5.02 (1.2)	7.54 (2.2)	1.01 (0.2)
No systemic therapy	Who had suboptimal cytoreductive surgery	1.01 (0.0)	1.01 (0.0)	5.02 (1.2)
Somatostatin analogue		9.03 (0.0)	6.02 (1.7)	5.02 (0.3)
Everolimus		7.03 (0.4)	7.03 (0.6)	5.02 (1.1)
Sunitinib		7.03 (0.5)	7.03 (0.5)	5.02 (1.2)
Cytotoxic chemotherapy		7.03 (1.0)	7.03 (0.9)	2.01 (1.2)
No systemic therapy	Who is not a candidate for surgery	1.01 (0.0)	1.01 (0.0)	5.02 (0.3)
Somatostatin analogue		9.03 (0.0)	5.02 (1.5)	6.53 (1.2)
Everolimus		7.03 (0.6)	8.03 (0.6)	5.02 (1.1)
Sunitinib		7.03 (0.8)	8.03 (0.4)	5.02 (1.2)
Cytotoxic chemotherapy		6.53 (1.1)	9.03 (0.8)	5.02 (1.5)

The medians of ratings represents the type of panel consensus that was reached for the particular patient scenario (cell):

¹Median rating 1-3 and no disagreement⁴ = “inappropriate”;

²Median rating 4-6 and no disagreement⁴ = “uncertain”; and

³Median rating 7-9 and no disagreement⁴ = “appropriate”; ⁴ > 2 responses in the range 1-3 and > 2 responses in the range 7-9 = “disagreement”.