Dr. Mark Lewis

Few oncologists know neuroendocrine tumors from both sides of the exam table: first as a patient diagnosed during training, and now as the doctor treating them. This physician brings both perspectives to one pressing question: when a tumor progresses on a somatostatin analog, what comes next? On this episode of BackTable Tumor Board, Dr. Aman Chauhan, a medical oncologist at UCSF, interviews Dr. Mark Lewis, director of gastrointestinal oncology at Intermountain Health in Salt Lake City, about treatment strategies for advanced neuroendocrine tumors beyond first-line therapy. They start with what progression on a somatostatin analog really means, how grade, Ki-67, primary site, and the pace of liver disease shape the next step, and why observation is sometimes the right call. Dr. Lewis explains how he sets expectations for PRRT after NETTER-1 and NETTER-2, including the small but real risk of secondary myelodysplasia and leukemia.