Targeted Oral Therapies in Progressive Small Bowel Neuroendocrine Tumor: Everolimus and Cabozantinib

This segment focuses on the role of targeted oral therapies in progressive small bowel neuroendocrine tumor, with particular attention to everolimus and cabozantinib. Dr Lieu discusses clinical scenarios in which these agents are preferred, including patients who are not candidates for peptide receptor radionuclide therapy or those who experience progression following radioligand treatment.

Everolimus is described as a well established option for non functioning gastrointestinal neuroendocrine tumors. Considerations related to metabolic effects, infection risk, and long term tolerability are discussed as important factors influencing patient selection. The speakers emphasize proactive monitoring and supportive care to maintain adherence and minimize treatment interruptions.

Cabozantinib is presented as an emerging option with activity across extrapancreatic neuroendocrine tumors. Dr Lieu highlights its distinct mechanism of action and discusses how it expands treatment options in later lines. Practical guidance is provided on dose modification, adverse event management, and patient education in routine practice.

Throughout the discussion, the importance of tailoring therapy to individual patient characteristics is emphasized. Rather than applying a uniform approach, treatment selection is guided by disease behavior, comorbidities, and prior therapy exposure. This segment offers practical insights into integrating targeted oral therapies into the management of progressive small bowel neuroendocrine tumor.