How tyrosine kinase inhibitors are used in advanced neuroendocrine tumors
Observes how targeted drug TKIs fit into treatment for advanced neuroendocrine tumors.
Plain-language title generated from the registry record
Registry title: Real World Positioning of Tyrosine Kinase Inhibitors (TKIs) Within Systemic Treatment Strategies for Advanced Neuroendocrine Tumors (NETs)
Key facts
- Where
- Angers, Caen, Clichy, Dijon, La Tronche, Lille, Lyon, Nantes, Paris, Pessac, Poitiers, Reims, Strasbourg, Tours, and Villejuif, FranceSee the 18 sites
Where in France
- CHU AngersAngers, FranceNo longer taking part
- CHU de CAENCaen, FranceNo longer taking part
- Hôpital Beaujon - APHPClichy, FranceNo longer taking part
- Chu Dijon BourgogneDijon, FranceNo longer taking part
- Chu Grenoble AlpesLa Tronche, FranceNo longer taking part
- CHRU de Lille - Hopital Claude HuriezLille, FranceNo longer taking part
- Hopital Edouard HerriotLyon, FranceNo longer taking part
- CHU NantesNantes, FranceNo longer taking part
- Hôpital Cochin APHPParis, FranceNo longer taking part
- Hôpital Européen Georges PompidouParis, FranceNo longer taking part
- Hôpital Saint Antoine APHPParis, FranceNo longer taking part
- Institut CurieParis, FranceNo longer taking part
- CHU Bordeaux - Hopital Haut-LevequePessac, FranceNo longer taking part
- CHU PoitiersPoitiers, FranceNo longer taking part
- CHU Reims Hopital Robert DebreReims, FranceNo longer taking part
- CHRU Strasbourg - Hôpital de HautepierreStrasbourg, FranceNo longer taking part
- CHU Tours - Hôpital TrousseauTours, FranceNo longer taking part
- Institut Gustave RoussyVillejuif, FranceNo longer taking part
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Hospices Civils de Lyon
- Trial code
- NCT07890012
- Record updated
- 22 October 2026
- Original description
Well differentiated neuroendocrine tumors (NETs) are rare and heterogeneous malignancies that frequently evolve toward advanced or metastatic disease, requiring long-term systemic treatment strategies delivered over multiple lines. Their management is complex and influenced by tumor-related factors-including primary site and grade-as well as disease burden, functional status, patient comorbidities, and access to available therapeutic options. As a result, real-world treatment pathways in advanced NETs are highly diverse.Read full original descriptionShow less
Real World Positioning of Tyrosine Kinase Inhibitors (TKIs) Within Systemic Treatment Strategies for Advanced Neuroendocrine Tumors (NETs)
Well differentiated neuroendocrine tumors (NETs) are rare and heterogeneous malignancies that frequently evolve toward advanced or metastatic disease, requiring long-term systemic treatment strategies delivered over multiple lines. Their management is complex and influenced by tumor-related factors-including primary site and grade-as well as disease burden, functional status, patient comorbidities, and access to available therapeutic options. As a result, real-world treatment pathways in advanced NETs are highly diverse.
In recent years, the systemic treatment landscape of advanced NETs has expanded beyond somatostatin analogues (SSA), peptide receptor radionuclide therapy (PRRT), and chemotherapy to include targeted therapies. Among these, multitarget tyrosine kinase inhibitors (TKIs) targeting tumor angiogenesis have progressively been incorporated into clinical practice. Their use varies according to tumor subtype, disease dynamics, prior treatments, and patient-related considerations, reflecting the absence of standardized sequencing algorithms.
In routine clinical practice, the choice and sequencing of TKIs are driven by individualized clinical decision-making rather than predefined treatment pathways. Their positioning within systemic treatment strategies is influenced by anticipated benefit, tolerability, prior toxicities, and practical constraints such as regulatory indications, access, and reimbursement conditions, which differ by tumor origin. Consequently, the real-world positioning of TKIs within treatment sequences remains insufficiently characterized at a national level.
"SEQUENCE-NET" is an ambispective observational study designed to prospectively document how TKIs are integrated into systemic treatment strategies for advanced pancreatic and extra-pancreatic NETs in routine clinical practice within the ENDOCAN-RENATEN network.
Inclusion: For main study :; Adult patients (≥ 18 years of age); Histologically confirmed advanced (metastatic or unresectable) well-differentiated NET of grade G1, G2, or G3 according to the WHO classification; Initiation of a TKI in routine clinical practice, serving as the index treatment line for prospective inclusion; Patient informed about the study with documented non-opposition, in accordance with applicable regulations; For the ancillary study :; Advanced/metastatic NETs (usually, ileal or lung NET, but other rare location/unknown are allowed) with clinical carcinoid syndrome and/or elevation of urinary 5HIAA> 2 upper limit of normal (ULN) Initiation of TKI in routine clinical practice, serving as the index treatment line for prospective inclusion.
Exclusion: Participation in an ongoing phase I, II, or III interventional clinical trial evaluating an investigational systemic therapy at the time of inclusion; Missing minimal required data preventing reconstruction of prior systemic treatment sequences or assessment of prospective endpoints; For the ancillary study :; For main study :; Poorly differentiated neuroendocrine carcinomas (NEC), including MiNEN with a NEC component; Patient not wanting to participate (filling in the questionnaires).