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D uring the ongoing COVID-19 pandemic, health care providers have had to make changes to the way they care for patients with neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs). Patients coming into clinics or hospitals are at risk of being exposed to the virus, and many may be immunocompromised due to therapy. Health care providers will also be exposed to patients carrying the virus and are at risk of contracting COVID-19, and the number of providers may become depleted. Many facilities have critical shortages of personal protective equipment (PPE), increasing the risk of transmission to both patients and health care professionals. This has important consequences for all aspects of caring for NET/NEC patients, including clinic visits, blood draws, imaging, chemotherapy/biologic therapy, administration of somatostatin analogs (SSAs), peptide receptor radionuclide therapy (PRRT), interventional radiologic procedures, and selection of patients for surgery. This document represents suggestions from the North American Neuroendocrine Tumor Society (NANETS) on how health care providers might make modifications to their care of NET/NEC patients in these unprecedented times, with the focus on decreasing risk to patients and health care professionals and preserving resources while delivering acceptable patient care. Portions of this document were built on guidelines produced by other professional organizations, which primarily include the American Society of Clinical Oncology (ASCO), the American College of Surgeons, the Society of Surgical Oncology, the Society of Nuclear Medicine and Molecular Imaging, the American Society of Therapeutic Radiation Oncology (ASTRO), Society of Interventional Radiology, and Centers for Disease Control and Prevention (CDC). We thank these organizations for their contributions, and links to their specific recommendations are included hereinafter. The care of NET/NEC patients should be individualized depending on their specific circumstances and the local conditions, which can change rapidly and could require future updates to this document. Facilities that are inundated with COVID-19 cases may need to ration care, whereas those less affected will need to prepare for a surge of patients and the resulting aftermath. This document is formatted as frequently asked questions regarding different aspects of NET/NEC patient care and the responses of a group of NET/NEC specialists representing NANETS.

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tissue was significantly associated with better OS for irinotecan-containing regimen (p ¼ 0.023). Conclusions:Our study demonstrated that IL-10 could act as a prognostic biomarker for mCRC patients undergoing irinotecan-containing chemotherapy.