Do you have a preferred systemic agent for patients with metastatic, unresectable, functional neuroendocrine tumors, such as an insulinoma, if the goal is to get a quick response?  

The management of metastatic unresectable neuroendocrine tumors depends on many factors including functionality, tumor burden, primary tumor, and SS expression. Usually, part of the management will be SSA to control hormonal secretion, however, we should be careful in patients with insulinoma. While...

I agree with what has been said above and I have the following additional comments. After obtaining somatostatin receptor imaging with DOTATATE PET and confirmed DOTATATE avidity (presence of somatostatin receptors), I typically start a somatostatin analog such as lanreotide or octreotide and I...

Agree with everything that has been discussed here. I learned a "pearl" from my mentor @Thorvardur (Thor) R. Halfdanarson which is dexamethasone. I have had success in two patients with dexamethasone as a temporizing measure. Of note, steroids downregulate SSTR so that could be relevant if consideri...