For patients who have a low Ki-67%, I typically start with Sandostatin in the 1st line setting. I will also consider a liver directed therapy, specifically Y90 radioembolization, if patients present with greater metastatic burden in the liver in addition to Sandostatin. If patients have a higher Ki-...

I assume you mean by (Progressive) metastatic pNETs, patients who are already progressed on SSAs. There are many points to consider in these patients: Grade: Are we talking about G1/2 vs G3 NET? This will affect our decision and how aggressive we should be. Are the met lesions exclusively hepati...