Treatment will depend on the location, extent of recurrent or residual disease, previous management and the patient’s preferences.
In managing people with NETs, treatment may include these options (refer to Step 4 for further detail):

• change in SSA – regimen and/or dose
• PRRT
• localised progression – consider liver-directed therapy and radiation therapy for bone metastasis
• widespread and systemic recurrence – consider systemic therapy – chemotherapy, targeted therapies, immunotherapy (remains investigational)
• pre-screen patient for any currently recruiting or imminent clinical trial
• palliation.

The potential goals of treatment should be discussed, respecting the patient’s cultural values. Wherever possible, written information should be provided.

Encourage early referral to clinical trials or accepting an invitation to participate in research.