Liver-Directed Therapies for Neuroendocrine Metastases

Ninety percent of patients with neuroendocrine tumors develop liver metastases, which are the foremost determinant of long-term survival. International guidelines recommend embolotherapy for progressive or symptomatic liver metastases. Clinical and imaging response rates to embolization are high and quite durable in low- and intermediate-grade tumors. While current guidelines are agnostic regarding embolization technique, differences in short- and long-term outcomes among bland, chemoembolization, and radioembolization are being elucidated. Integration and sequencing liver-directed and systemic therapies to create personalized care plans for each patient require multidisciplinary management teams for NETs.