Systemic treatment in unresectable metastatic well-differentiated carcinoid tumors: consensus results from a modified delphi process

Jonathan R StrosbergEdward M Wolin


This study aimed to develop expert consensus for the use of systemic treatments for unresectable metastatic well-differentiated (grade 1-2) carcinoid tumors using the RAND/UCLA modified Delphi process. After a comprehensive literature review, 404 patient scenarios addressing the use of systemic treatments for carcinoid tumors were constructed. A multidisciplinary panel of 10 physicians assessed the scenarios as appropriate, inappropriate, or uncertain (on a 1-9 scale) or as an area of disagreement before and after an extended discussion of the evidence. Experts were medical and surgical oncologists, interventional radiologists, and gastroenterologists. Among rated scenarios, disagreement decreased from 14% before the meeting to 4% after. Consensus statements about midgut carcinoids included the following: (1) Somatostatin analogs are appropriate as first-line therapy for all patients; (2) In patients with uncontrolled secretory symptoms, it is appropriate to increase the dose/frequency of octreotide long-acting repeatable up to 60 mg every 4 weeks or up to 40 mg every 3 weeks as second-line therapy for refractory carcinoid syndrome. Other options may also be appropriate. Consensus was similar for non-midgut carcinoids. The Delp...Continue Reading


Sep 11, 1986·The New England Journal of Medicine·L K KvolsR G Hahn
Oct 1, 1987·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·C G Moertel
Jun 7, 1986·Lancet
May 1, 1969·The Journal of Histochemistry and Cytochemistry : Official Journal of the Histochemistry Society·A G Pearse
Jan 1, 1995·American Journal of Surgery·F G QueL K Kvols
Dec 24, 1997·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B ErikssonK Oberg
Jun 25, 1998·The New England Journal of Medicine·P G ShekelleR E Park
Mar 18, 1999·The New England Journal of Medicine·M H Kulke, R J Mayer
Feb 16, 2000·Obstetrics and Gynecology·M S BroderS J Bernstein
May 3, 2000·Alimentary Pharmacology & Therapeutics·P TomassettiL Gullo
May 23, 2002·World Journal of Surgery·Per HellmanAnders Elvin
Jul 2, 2003·Journal of the American College of Surgeons·Juan M SarmientoFlorencia G Que
Feb 2, 1963·Lancet·E D WILLIAMS, M SANDLER
Oct 13, 2004·Neuroendocrinology·Philippe Ruszniewski, Dermot O'Toole
Oct 20, 2005·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Rudolf ArnoldChristian N Arnold
Mar 2, 2006·Cancer Control : Journal of the Moffitt Cancer Center·Jonathan R StrosbergLarry K Kvols
Mar 17, 2007·Fertility and Sterility·Ian S FraserUNKNOWN Writing Group for this Menstrual Agreement Process
Jan 8, 2008·The Lancet Oncology·Irvin M ModlinAnders Sundin
Mar 8, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·James C YaoJaffer A Ajani
Jun 3, 2008·Annals of Oncology : Official Journal of the European Society for Medical Oncology·T R HalfdanarsonG M Petersen
Jun 21, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·James C YaoDouglas B Evans
Jul 10, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Matthew H KulkeCharles S Fuchs
Jul 29, 2010·Pancreas·Aaron I VinikUNKNOWN North American Neuroendocrine Tumor Society (NANETS)
Jul 29, 2010·Pancreas·Matthew H KulkeUNKNOWN North American Neuroendocrine Tumor Society (NANETS)
Jul 29, 2010·Pancreas·Jonathan R StrosbergUNKNOWN North American Neuroendocrine Tumor Society (NANETS)
Oct 15, 2010·Annals of Oncology : Official Journal of the European Society for Medical Oncology·K E Öberg
Feb 11, 2011·The New England Journal of Medicine·Eric RaymondPhilippe Ruszniewski
Feb 11, 2011·The New England Journal of Medicine·James C YaoUNKNOWN RAD001 in Advanced Neuroendocrine Tumors, Third Trial (RADIANT-3) Study Group

❮ Previous
Next ❯


May 9, 2014·European Journal of Nuclear Medicine and Molecular Imaging·Vikas PrasadIrvin M Modlin
Jan 9, 2016·Current Oncology Reports·Venkata K PokuriRenuka Iyer
Jan 23, 2016·Asia-Pacific Journal of Clinical Oncology·Elizabeth A BurmeisterUNKNOWN Pancreatic Cancer Clinical Working Group
May 28, 2014·Journal of Surgical Oncology·Ramon E A JacobsParesh C Shah
Sep 16, 2015·The Lancet Oncology·Kjell ObergJames Goldenring
Feb 17, 2015·World Journal of Gastroenterology : WJG·Michael S BroderDasha Cherepanov
Feb 13, 2018·Case Reports in Gastroenterology·Maridi Aerts, Hendrik Reynaert
Mar 6, 2015·World Journal of Gastroenterology : WJG·Jonathan R StrosbergMichael S Broder

❮ Previous
Next ❯

Related Concepts

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.


Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.


Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.