What I’ve been discussing today to this multidisciplinary meeting on neuroendocrine tumours is how we can better tailor treatment for those patients. Neuroendocrine disease is a very special cancer because those patients have a slow-growing cancer and they’re going to live for many years so they will be exposed to many different treatments. There is a lot of work to do to better choose one treatment but to better choose how to sequence treatments. As interventional oncologists we can provide radiofrequency ablation for very small tumours; we can provide intra-arterial therapy for liver dominant disease. All the discussion today is how to order the treatment one after the other, of course, for better results, better control of the disease. But we don’t have to forget that those patients will have many treatments, they will have many side effects and many complications and maybe our first goal is to lower the complications within the same time trying to improve treatment over a long period of time.
What are the complications associated with this?
The complications which are associated with neuroendocrine cancer treatment, it’s interesting to see that the grade 3 complications after a single treatment are in the range of 15%. But as far as we are giving more and more treatments the complication or the number, or the percent, of more than grade 3 is increasing. When those patients show up in fifth line therapy we have up to 45% grade 3 complications.