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Updated: Jun 1, 2026
05:42
Robotic Enucleation of an Intra-Pancreatic Insulinoma in the Pancreatic Head
Published on: January 3, 2020
New therapeutic options for metastatic malignant insulinomas
Wouter W de Herder1, Ellen van Schaik, Dik Kwekkeboom
1Department of Internal Medicine, Sector of Endocrinology, Erasmus MC, Rotterdam, the Netherlands. w.w.deherder@erasmusmc.nl
Clinical Endocrinology
|June 9, 2011
Summary
Metastatic insulinomas, rare but aggressive pancreatic neuroendocrine tumors, have new treatment options. Targeted therapies like everolimus and peptide receptor radiotherapy offer improved survival and symptom control for patients.
Area of Science:
- Oncology
- Endocrinology
- Medical Therapeutics
Background:
- Insulinomas are the most common functioning pancreatic neuroendocrine tumors.
- Most (>90%) are nonmetastatic and surgically curable.
- Fewer than 10% present with distant metastases (liver, bone), associated with <2-year median survival.
Purpose of the Study:
- To review recent advancements in managing metastatic insulinomas.
- To highlight novel therapeutic strategies for this challenging condition.
Main Methods:
- Review of current literature on targeted therapies and peptide receptor radiotherapy for metastatic pancreatic neuroendocrine tumors.
- Analysis of treatment outcomes, including tumor control and symptom management (hypoglycemia, hyperglycemia).
Main Results:
- Everolimus and sunitinib are approved targeted therapies for metastatic pancreatic neuroendocrine tumors.
- Everolimus offers an added benefit of potentially increasing blood glucose levels.
- Peptide receptor radiotherapy with radiolabeled somatostatin analogs effectively controls tumor growth and hypoglycemia, even with tumor regrowth.
Conclusions:
- New therapeutic modalities expand treatment options for metastatic insulinomas.
- A 'tailor-made' approach is crucial for optimizing patient outcomes.
- These advancements improve the management of advanced insulinoma cases.
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