Neuroendocrine tumors of pancreas (
PNET) are very rare, consisting of heterogeneous histological subtypes with a variable natural history and different clinical manifestations. Although the vast majority of these
neoplasms are sporadic, it is possible to be part of a genetic syndrome such as
multiple endocrine neoplasia 1 (MEN-1) or
tuberous sclerosis (
TSC). When systemic treatment is required the options are limited and management strategy is generally based on experts' consensus or clinical experience. The prognosis is usually better than in pancreatic
adenocarcinoma, though poorly differentiated
PNET behave aggressively and survival is shortened. Since last year, there has been a significant advance in the management of
PNET, after reported data confirmed the efficacy of
everolimus, an mTOR inhibitor, in patients with advanced disease. At the 2011 American Society of Clinical Oncology (ASCO) Gastrointestinal Symposium, updated results of the phase III trial (RADIANT-3) regarding the efficacy of
everolimus in
PNET (Abstract #158) were reported, along with the results of a subgroup analysis of the Japanese patients enrolled in this study (Abstract #289). Another agent with promising activity in
PNET which will be discussed in this review is
sunitinib, a
biological agent with multikinase inhibitor properties (Abstract #244).