Targeted and immunotherapy drugs for neuroendocrine cancer

Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Other drugs help the immune system to attack cancer. They are called immunotherapies.

Some drugs work in more than one way. So they are targeted as well as working with the immune system. 

You might have targeted drugs to treat a neuroendocrine tumour (NET). These drugs include sunitinib and everolimus. 

You might have immunotherapy to treat lung neuroendocrine carcinoma (NEC). These drugs include atezolizumab and durvalumab

When you might have targeted or immunotherapy drugs for neuroendocrine cancer

Your treatment plan depends on what type of neuroendocrine cancer you have. 

Neuroendocrine tumours (NETs)

You might have a targeted drug for a NET that has spread to other parts of the body (metastatic). Or if you can't have surgery to remove the NET. You usually have it when other treatments are no longer working.

For pancreatic NETs, you might have one of the following targeted drugs:

• sunitinib 
• everolimus

For other types of NETs that start in the digestive system or the lungs, you might have everolimus. 

Neuroendocrine carcinoma (NEC)

For lung NEC you usually have chemotherapy drugs. You may have these drugs together with the immunotherapy drugs atezolizumab or durvalumab.

Sunitinib

Sunitinib is also called Sutent. It is a type of targeted drug called a protein kinase inhibitor. Protein kinase is a chemical messenger (an enzyme) that tell cells to grow. Sunitinib blocks the protein kinase, so it can stop the NET from growing. 

You usually take sunitinib capsules every day, with or without food.

Everolimus

Everolimus is also called Afinitor. It works by stopping a protein called mTOR from working properly. mTOR controls other proteins and triggers cancer cells to grow. So everolimus can stop the NET from growing or may slow it down. 

You usually have everolimus as a tablet that you swallow every day, with or without food.

Atezolizumab

Atezolizumab is also called Tecentriq. It works by blocking a protein that stops the immune system from working properly and attacking cancer cells. It helps to make your immune system find and kill cancer cells.   It is a type of immunotherapy for some types of lung neuroendocrine carcinoma.

You usually have atezolizumab as an injection under the skin (subcutaneously).

Durvalumab

Durvalumab is also called Imfinzi. It is a type of immunotherapy called a checkpoint inhibitor.  It seeks out cancer cells by looking for the PD-L1 protein and attaching to it. The immune system then recognises the marked cells and kills them. You might have durvalumab for some types of lung neuroendocrine cancer. 

You have durvalumab as a drip into your bloodstream (intravenously).

Side effects

Everyone is different and the side effects vary from person to person. The side effects you have depend on:

• which drug you have
• whether you have it alone or with other drugs
• the amount of drug you have (the dose)
• your general health

A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on. For more information about the side effects of your treatment, go to the individual drug pages.

Research into targeted cancer drugs and neuroendocrine cancer

Your doctor might ask you to have treatment with a targeted or immunotherapy drug as part of a clinical trial. 

We have more information about research and clinical trials in the sections about the different types of NETs.

Coping

Treatment for neuroendocrine cancer can be difficult to cope with for some people. Your nurse will give you phone numbers to call if you have any problems at home.