62. Advanced Neuroendocrine Tumour - Later Lines of Therapy

"We go to the moon and other places not because they are easy, but because they are hard." So spoke US President John F. Kennedy, in a speech that galvanised the American public and fostered widespread support for the space race and the Apollo space program that would culminate in Neil Armstrong and Buzz Aldrin landing on the Moon on July 20, 1969. A similar approach must be taken to the treatment of neuroendocrine tumours, a rare and difficult-to-treat cancer type requiring inventiveness, preparation and lateral thinking (almost) on the level of the Apollo and Soyuz astronauts.

Last week, Michael and Josh discussed the front-line treatment of low-grade, well-differentiated neuroendocrine tumours. However, it always pays to be prepared. To that end, today our intrepid "onconauts" explore the lesser-known frontiers of later options, focussing on the competing everolimus and sunitinib. Will one option triumph over the other and reach the surface of the tumour first? Listen on to find out.

Links to studies discussed in this episode (subscription may be required):

RADIANT: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00817-X/fulltext

Raymond et al (sunitinib): https://www.nejm.org/doi/full/10.1056/nejmoa1003825

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