Gastroenteropancreatic neuroendocrine tumors (GEP-NET) are a very heterogeneous group of neoplasms, stratified by the World Health Organization (WHO) classification. However, tumors of different behavior coexist within each category.
The use of somatostatin analogues (SSA) is currently the most suitable first-line therapy for most.
However, the expectation of PFS is far from being homogeneous. Thus, in the phase III PROMID trial, LAR octreotide improved PFS over placebo. However, the median PFS ranged from 29.4 to 4.6 months in different subgroups. Similarly, in the phase III trial CLARINET, lanreotide extended release (Autogel) prolonged PFS against placebo. But crucially, SSA-treated midgut, hindgut, and pancreatic tumors had different behaviors. However, these data do not serve to make individualized predictions integrating the simultaneous effect of several predictors. This information may be interesting in different situations. In particular, an accelerated expansion is expected in the availability of targeted therapies that can be administered concurrently with somatostatin analogues. Thus, a prognostic model may be important in determining when a patient should be treated in monotherapy or in combination, so that individualized decisions can be made based on the evidence-based prediction of risk.