晚期胃肠胰神经内分泌肿瘤 (GEP-NEN) 的循证治疗决策需要以患者为中心的个体化决策，考虑患者和癌症特征。创建一份易于理解的指导文件，向临床医生和患者提供有关生物标志物的教育，为不可切除的患者提供预后和治疗信息或转移性 GEP-NEN。召开了多学科小组现场研讨会来定义方法。我们回顾了 2016 年 1 月至 2023 年 1 月在 PubMed (MEDLINE) 上发表的英文文章和相关会议摘要，以研究不可切除或转移性 GEP-NEN 的预后和治疗信息特征。纳入研究的数据用于形成基于证据的建议。证据的质量和建议的强度是使用建议分级、评估、制定和评价框架来确定的。采用改进的德尔菲法通过电子调查达成共识。共鉴定出 131 篇出版物，其中包括 8 篇系统评价和荟萃分析、6 篇随机临床试验、29 篇前瞻性研究和 88 篇回顾性队列研究。经过两轮调查，制定了 24 条建议和 5 条良好临床实践声明，并得到了小组成员的充分共识。建议重点关注肿瘤和功能成像特征、血液生物标志物和类癌性心脏病。针对有症状的类癌综合征提出了一项强烈建议，为中肠神经内分泌肿瘤的治疗提供依据。有条件地建议使用分级、形态、原发部位和尿 5-羟基吲哚乙酸水平来指导治疗。该指导文件得到了英联邦神经内分泌肿瘤合作组织和北美神经内分泌肿瘤协会的认可。研究结果表明，选定的因素有足够的证据为 GEP-NEN 的护理提供信息，但大多数生物标志物的证据薄弱。本文可能有助于指导管理并确定未来研究的差距，以推进个性化医疗并改善 GEP-NEN 患者的治疗结果。

Evidence-based treatment decisions for advanced gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) require individualized patient-centered decision-making that accounts for patient and cancer characteristics.To create an accessible guidance document to educate clinicians and patients on biomarkers informing prognosis and treatment in unresectable or metastatic GEP-NENs.A multidisciplinary panel in-person workshop was convened to define methods. English language articles published from January 2016 to January 2023 in PubMed (MEDLINE) and relevant conference abstracts were reviewed to investigate prognostic and treatment-informing features in unresectable or metastatic GEP-NENs. Data from included studies were used to form evidence-based recommendations. Quality of evidence and strength of recommendations were determined using the Grading of Recommendations, Assessment, Development and Evaluations framework. Consensus was reached via electronic survey following a modified Delphi method.A total of 131 publications were identified, including 8 systematic reviews and meta-analyses, 6 randomized clinical trials, 29 prospective studies, and 88 retrospective cohort studies. After 2 rounds of surveys, 24 recommendations and 5 good clinical practice statements were developed, with full consensus among panelists. Recommendations focused on tumor and functional imaging characteristics, blood-based biomarkers, and carcinoid heart disease. A single strong recommendation was made for symptomatic carcinoid syndrome informing treatment in midgut neuroendocrine tumors. Conditional recommendations were made to use grade, morphology, primary site, and urinary 5-hydroxyindoleacetic levels to inform treatment. The guidance document was endorsed by the Commonwealth Neuroendocrine Tumour Collaboration and the North American Neuroendocrine Tumor Society.The study results suggest that select factors have sufficient evidence to inform care in GEP-NENs, but the evidence for most biomarkers is weak. This article may help guide management and identify gaps for future research to advance personalized medicine and improve outcomes for patients with GEP-NENs.