What is your first line treatment for progressive well differentiated metastatic (and unresectable) pancreatic neuroendocrine tumors?  

I assume you mean by (Progressive) metastatic pNETs, patients who are already progressed on SSAs. There are many points to consider in these patients: Grade: Are we talking about G1/2 vs G3 NET? This will affect our decision and how aggressive we should be. Are the met lesions exclusively hepati...