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Mairéad G McNamara Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, UK
Division of Cancer Sciences, University of Manchester, Manchester, UK

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Jean-Yves Scoazec Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
Université Paris Sud, Faculté de Médecine de Bicêtre, Le Kremlin-Bicêtre, France

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Thomas Walter Department of Gastroenterology and Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France

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, 2018 , Rekhtman et al . 2016 ). In the GEP arena, most of the available studies have included not only ‘pure’ NECs, but also mixed neuroendocrine-non neuroendocrine neoplasms. Mixed neuroendocrine non-neuroendocrine neoplasms from the gastro-entero-pancreatic

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Krystallenia I Alexandraki Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Ariadni Spyroglou Second Department of Surgery, Aretaieion Hospital, National and Kapodistrian University of Athens, Athens, Greece
Clinic for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland

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Stylianos Kykalos Second Department of Propaedeutic Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece

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Kosmas Daskalakis Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Endocrine Unit, First Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Georgios Kyriakopoulos Department of Pathology, Evaggelismos Hospital, Athens, Greece

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Georgios C Sotiropoulos Clinic for Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland

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Gregory A Kaltsas Endocrine Unit, First Department of Propaedeutic Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Ashley B Grossman Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, UK
NET Unit, Royal Free Hospital, London, UK
Barts and the London School of Medicine, London, UK

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'Neuroendocrine Tumors/physiology' (Mesh) OR 'Neuroendocrine Tumors/physiopathology' (Mesh) OR 'Gastro-enteropancreatic neuroendocrine tumor' (Supplementary Concept). The databases were searched through until May 2020. We screened 244 articles: all articles were

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Satya Das Vanderbilt University Medical Center, Division of Hematology and Oncology, Department of Medicine, Nashville, Tennessee, USA

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Liping Du Vanderbilt University of Medical Center, Department of Biostatistics, Nashville, Tennessee, USA

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Aimee Schad Rush Medical Center, Department of Medicine, Chicago, Illinois, USA

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Shikha Jain Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA

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Aaron Jessop Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

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Chirayu Shah Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

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David Eisner Vanderbilt University Medical Center, Division of Hematology and Oncology, Department of Medicine, Nashville, Tennessee, USA

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Dana Cardin Vanderbilt University Medical Center, Division of Hematology and Oncology, Department of Medicine, Nashville, Tennessee, USA

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Kristen Ciombor Vanderbilt University Medical Center, Division of Hematology and Oncology, Department of Medicine, Nashville, Tennessee, USA

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Laura Goff Vanderbilt University Medical Center, Division of Hematology and Oncology, Department of Medicine, Nashville, Tennessee, USA

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Marques Bradshaw Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

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Dominique Delbeke Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

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Martin Sandler Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA

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Jordan Berlin Vanderbilt University Medical Center, Division of Hematology and Oncology, Department of Medicine, Nashville, Tennessee, USA

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) in 2018 for patients with gastroenteropancreatic NETs with somatostatin receptor positive disease based on the NETTER-1 study and several large cohort studies from Europe ( Brabander et al. 2017 , Strosberg et al. 2017 ). Although neither EMA nor

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Aura D Herrera-Martínez Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain

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Leo J Hofland Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands

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María A Gálvez Moreno Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain

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Justo P Castaño Maimonides Institute for Biomedical Research of Cordoba (IMIBIC); Reina Sofia University Hospital, Córdoba, Spain

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Wouter W de Herder Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands

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Richard A Feelders Division of Endocrinology, Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands

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also referred to as gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) ( Modlin et al . 2008 , Xavier et al . 2016 ). The annual NENs incidence increases over time, although it is not known whether this is a true increase in NEN incidence

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Tessa Brabander ENETS Center of Excellence, Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands

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Julie Nonnekens ENETS Center of Excellence, Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
Department of Molecular Genetics, Erasmus Medical Center, Rotterdam, The Netherlands

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Johannes Hofland ENETS Center of Excellence, Section of Endocrinology, Department of Internal Medicine, Erasmus Cancer Institute, Erasmus Medical Center, Rotterdam, The Netherlands

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Background Well-differentiated neuroendocrine neoplasms (NENs) of the gastroenteropancreatic system are characterised by a low mutational burden and indolent tumour growth. These features contribute to the poor success rates of cytotoxic

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Wouter W de Herder Division of Endocrinology, Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands

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Erik P Krenning Cyclotron BV, Rotterdam, Netherlands

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Gabriel P Krestin Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands

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R de Jong M de Herder WW Krenning EP 2010 Somatostatin-receptor-based imaging and therapy of gastroenteropancreatic neuroendocrine tumors. Endocrine-Related Cancer 17 R53 – R73 . ( doi:10.1677/ERC-09-0078 ) Teunissen JJ

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Maria Chiara Zatelli Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Giuseppe Fanciulli Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Pasqualino Malandrino Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Valeria Ramundo Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Antongiulio Faggiano Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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Annamaria Colao Section of Endocrinology and Internal Medicine, Neuroendocrine Tumours Unit, Endocrinology Unit, Department of Clinical Medicine and Surgery, Thyroid and Parathyroid Surgery Unit, Department of Medical Sciences, University of Ferrara, Via Aldo Moro 8, 44124 Cona – Ferrara, Italy

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on behalf of NIKE Group
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. (2015) identified KRAS mutations in 13 colorectal and two in gastric neuroendocrine carcinomas (NEC) among 53 cases of gastro-entero-pancreatic NEC. KRAS somatic oncogenic mutations characterize cancer patients who do not benefit from everolimus

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Dimitrios Papantoniou Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden
Department of Oncology, Ryhov County Hospital, Jönköping, Sweden

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Malin Grönberg Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden

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Espen Thiis-Evensen Oslo University Hospital, Rikshospitalet, Deptartment of Organ Transplant, Oslo, Norway

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Halfdan Sorbye Haukeland Hospital, Deptartment of Oncology, Bergen, Norway
University of Bergen, Deptartment of Clinical Medicine, Bergen, Norway

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Kalle Landerholm Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Department of Surgery, Ryhov County Hospital, Jönköping, Sweden

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Staffan Welin Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden

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Eva Tiensuu Janson Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden

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C Schade-Brittinger C Barth P Moll R 2005 Octreotide versus octreotide plus interferon-alpha in endocrine gastroenteropancreatic tumors: a randomized trial . Clinical Gastroenterology and Hepatology 3 761 – 771 . ( https://doi.org/10.1016/S

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Matthew H Kulke Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Dana-Farber Cancer Institute, 44 Binney Street, Boston, Massachusetts 02115, USA

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IFN-α, is controversial ( Saltz et al. 1993 ). Radiologic evidence of tumor regression following treatment with these agents is rare. In a small study involving 21 patients with metastatic gastroenteropancreatic neuroendocrine tumors, a combined

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Mojun Zhu Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA

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Karl R Sorenson Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA

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Rebecca Liu Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA

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Bonnie E Gould Rothberg Smilow Cancer Hospital, Yale-New Haven Health System, New Haven, Connecticut, USA

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Thorvardur R Halfdanarson Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA

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the following three queries: (pancreas OR pancreatic OR gastroenteropancreatic) AND (neuroendocrine OR endocrine) AND (prognos* OR surviv* OR predict*) AND (immunost* OR immunohistoch*) (pancreas) OR pancreatic OR gastroenteropancreatic

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