奥曲肽（Octreotide）和兰曲肽（Lanreotide）是目前临床实践中可用的两种生长抑素类似物（SSA）。它们首先被批准用于控制功能性神经内分泌肿瘤（NET）相关的临床综合症（主要是类癌综合症），后来被用于控制晚期低/中级别NET的肿瘤生长。尽管多年来有关它们的作用，特别是作为抗增殖治疗的证据不断增加，但一些临床指征仍然存在争议。在意大利医学肿瘤学会（AIOM）的要求下，来自各种专业，包括医学肿瘤学、内分泌学和胃肠病学，因其临床和研究活动深度涉及NET的一组临床医生，审查了八个开放性问题，对证据和指南进行了批判性评估，并分享了临床实用信息。这些问题涉及以下使用场景：耐药于标签剂量的功能性和非功能性NET、第一线转移性肺NET、与其他具有抗增殖作用的治疗联合使用、NET维持响应其他治疗、辅助治疗、Ki-67相关截止值、生长抑素受体成像、安全性和可行性。对于这些临床背景大部分的证据水平并不是绝对的，因此建议在极其特异的情况下区分例行和偶发使用。调查了主要欧洲指南（ENETS，欧洲神经内分泌肿瘤学会和ESMO，欧洲医学肿瘤学会）对此类特定问题的提及，以及它们的立场。然而，如果仔细在NET专业的多学科团队中讨论个别患者的情况，可能会做出不同的临床决策。版权所有© 2023 Elsevier Ltd.

Octreotide and lanreotide are the two somatostatin analogs (SSA) currently available in clinical practice. They have been approved first to control the clinical syndrome (mainly carcinoid syndrome) associated with functioning neuroendocrine tumors (NET) and later for tumor growth control in advanced low/intermediate grade NET. Although evidence regarding their role, especially as antiproliferative therapy, has been increasing over the years some clinical indications remain controversial. Solicited by AIOM (Italian Association of Medical Oncology) a group of clinicians from various specialties, including medical oncology, endocrinology, and gastroenterology, deeply involved in NET for their clinical and research activity, addressed eight open questions, critically reviewing evidence and guidelines and sharing clinical take-home messages. The questions regarded the use of long-acting octreotide and lanreotide in the following settings: functioning and non-functioning NET refractory to label dose, first-line metastatic pulmonary NET, combination with other therapy with an antiproliferative intent, maintenance in NET responding to other therapies, adjuvant treatment, Ki-67-related cut-off, somatostatin receptor imaging, safety, and feasibility. The level of evidence is not absolute for the majority of these clinical contexts, so it is recommended to distinguish routine versus sporadic utilization in very selected cases. Mention of such specific issues by the main European guidelines (ENETS, European Neuroendocrine Tumor Society, and ESMO, European Society for Medical Oncology) was explored and their position reported. However, different clinical decisions on single patients could be made if the case is carefully discussed within a NET-dedicated multidisciplinary team.Copyright © 2023 Elsevier Ltd. All rights reserved.