Australasian consensus statement on the identification, prevention and management of hormonal crises in patients with neuroendocrine neoplasms (NENs) undergoing peptide receptor radionuclide therapy (PRRT)

Hormonal crises are a rare but increasingly recognised phenomenon following peptide receptor radionuclide therapy (PRRT) in patients with neuroendocrine neoplasms (NENs). Due to the paucity of published studies, approaches to the identification, prevention and management of risk factors are inconsistent between different institutions. This consensus statement aims to provide guidance in patients undergoing PRRT. Our statement has been created on the basis of clinical demand and concerns regarding the precipitation of hormonal crises. A formal literature review was conducted to identify available studies. A total of 19 Australian and New Zealand experts in the fields of medical oncology, nuclear medicine, anaesthesia and endocrinology collaborated on this consensus statement. The main focus is on carcinoid crises. Other hormonal crises seen in patients with functional pancreatic NENs are addressed briefly. These recommendations are relevant to PRRT centres internationally and should be tailored to local experience and available resources.