OBJECTIVES: This study aimed to develop expert consensus for the use of systemic treatments for unresectable metastatic well-differentiated (grade 1-2) carcinoid tumors using the RAND/UCLA modified Delphi process. METHODS: After a comprehensive literature review, 404 patient scenarios addressing the use of systemic treatments for carcinoid tumors were constructed. A multidisciplinary panel of 10 physicians assessed the scenarios as appropriate, inappropriate, or uncertain (on a 1-9 scale) or as an area of disagreement before and after an extended discussion of the evidence. RESULTS: Experts were medical and surgical oncologists, interventional radiologists, and gastroenterologists. Among rated scenarios, disagreement decreased from 14% before the meeting to 4% after. Consensus statements about midgut carcinoids included the following: (1) Somatostatin analogs are appropriate as first-line therapy for all patients; (2) In patients with uncontrolled secretory symptoms, it is appropriate to increase the dose/frequency of octreotide long-acting repeatable up to 60 mg every 4 weeks or up to 40 mg every 3 weeks as second-line therapy for refractory carcinoid syndrome. Other options may also be appropriate. Consensus was similar for non-midgut carcinoids. CONCLUSIONS: The Delphi process provided a structured methodological approach to assist clinician experts in reaching consensus on the appropriateness of specific medical therapies for the treatment of advanced carcinoid tumors.
OBJECTIVES: This study aimed to develop expert consensus for the use of systemic treatments for unresectable metastatic well-differentiated (grade 1-2) carcinoid tumors using the RAND/UCLA modified Delphi process. METHODS: After a comprehensive literature review, 404 patient scenarios addressing the use of systemic treatments for carcinoid tumors were constructed. A multidisciplinary panel of 10 physicians assessed the scenarios as appropriate, inappropriate, or uncertain (on a 1-9 scale) or as an area of disagreement before and after an extended discussion of the evidence. RESULTS: Experts were medical and surgical oncologists, interventional radiologists, and gastroenterologists. Among rated scenarios, disagreement decreased from 14% before the meeting to 4% after. Consensus statements about midgut carcinoids included the following: (1) Somatostatin analogs are appropriate as first-line therapy for all patients; (2) In patients with uncontrolled secretory symptoms, it is appropriate to increase the dose/frequency of octreotide long-acting repeatable up to 60 mg every 4 weeks or up to 40 mg every 3 weeks as second-line therapy for refractory carcinoid syndrome. Other options may also be appropriate. Consensus was similar for non-midgut carcinoids. CONCLUSIONS: The Delphi process provided a structured methodological approach to assist clinician experts in reaching consensus on the appropriateness of specific medical therapies for the treatment of advanced carcinoid tumors.
Authors: Jonathan R Strosberg; George A Fisher; Al B Benson; Lowell B Anthony; Bulent Arslan; John F Gibbs; Edward Greeno; Renuka V Iyer; Michelle K Kim; William J Maples; Philip A Philip; Edward M Wolin; Dasha Cherepanov; Michael S Broder Journal: World J Gastroenterol Date: 2015-02-28 Impact factor: 5.742
Authors: Michael S Broder; David Beenhouwer; Jonathan R Strosberg; Maureen P Neary; Dasha Cherepanov Journal: World J Gastroenterol Date: 2015-02-14 Impact factor: 5.742
Authors: Eliza B Geer; Alejandro Ayala; Vivien Bonert; John D Carmichael; Murray B Gordon; Laurence Katznelson; Ekaterina Manuylova; Ismat Shafiq; Vijaya Surampudi; Ronald S Swerdloff; Michael S Broder; Dasha Cherepanov; Marianne Eagan; Jackie Lee; Qayyim Said; Maureen P Neary; Beverly M K Biller Journal: Pituitary Date: 2017-08 Impact factor: 4.107
Authors: Kjell Oberg; Irvin M Modlin; Wouter De Herder; Marianne Pavel; David Klimstra; Andrea Frilling; David C Metz; Anthony Heaney; Dik Kwekkeboom; Jonathan Strosberg; Timothy Meyer; Steven F Moss; Kay Washington; Edward Wolin; Eric Liu; James Goldenring Journal: Lancet Oncol Date: 2015-09 Impact factor: 41.316
Authors: Jonathan R Strosberg; Al B Benson; Lynn Huynh; Mei Sheng Duh; Jamie Goldman; Vaibhav Sahai; Alfred W Rademaker; Matthew H Kulke Journal: Oncologist Date: 2014-08-05
Authors: Kjell Oberg; Eric Krenning; Anders Sundin; Lisa Bodei; Mark Kidd; Margot Tesselaar; Valentina Ambrosini; Richard P Baum; Matthew Kulke; Marianne Pavel; Jaroslaw Cwikla; Ignat Drozdov; Massimo Falconi; Nicola Fazio; Andrea Frilling; Robert Jensen; Klaus Koopmans; Tiny Korse; Dik Kwekkeboom; Helmut Maecke; Giovanni Paganelli; Ramon Salazar; Stefano Severi; Jonathan Strosberg; Vikas Prasad; Aldo Scarpa; Ashley Grossman; Annemeik Walenkamp; Mauro Cives; Irene Virgolini; Andreas Kjaer; Irvin M Modlin Journal: Endocr Connect Date: 2016-08-31 Impact factor: 3.335