Octreotide 150-250 mcg sc tid or depot 20 mg im q4w

Saltz L et al. Octreotide as an antineoplastic agent in the treatment of functional and nonfunctional neuroendocrine tumors. Cancer 1993; 72:244 (link to the article).

Streptozocin + 5-FU
Streptozocin 500 mg/m2/d iv d1-5
5-FU 400 mg/m2/d iv d1-5
Q6w

Moertel CG et al. Streptozocin-doxorubicin, streptozocin-fluorouracil, or chlorozotocin in the treatment of  advanced islet-cell carcinoma. N Eng J Med 1992; 326:519 (link to the article).

Streptozocin + Doxorubicin
Streptozocin 500 mg/m2/d iv d1-5
Doxorubicin (Adriamycin) 50 mg/m2 iv d1, 22

Moertel CG et al. Streptozocin-doxorubicin, streptozocin-fluorouracil, or chlorozotocin in the treatment of  advanced islet-cell carcinoma. N Eng J Med 1992; 326:519 (link to the article).

Etoposide + Cisplatin
Etoposide (VP-16) 130 mg/m2/d civi d1-3
Cisplatin (CDDP) 45 mg/m2/d civi d2-3
Q3w

Moertel CG et al. Treatment of neuroendocrine carcinoma with combined etoposide and cisplatin. Evidence of major therapeutic activity in the anaplastic variants of these neoplasms. Cancer 1991; 68:227 (link to the article).

Sunitinib
Sunitinib (Sutent) 50 mg po qd for 4 weeks, repeat after 2 weeks rest. May escalate to 62.5 mg and 75 mg. Continue treat until disease progression or unacceptable toxicity

Kulke MH et al. Activity of sunitinib in patients with advanced neuroendocrine tumors. J Clin Oncol 2008; 26:3403 (link to the article).