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Pancreatic neuroendocrine tumors (pNETs) are rare well-differentiated neoplasms which can be functional or nonfunctional.They tend to have a worse prognosis than their counterpart carcinoid tumors. Current systemic treatment optionsfor advanced, unresectable disease include somatostatin analogs, everolimus and sunitinib. Low response rates and toxicityprofiles have, thus far, limited the widespread use of cytotoxic chemotherapy in this setting. In this update, we review threeabstracts from the 2014 ASCO Gastrointestinal Cancers Symposium that present outcomes of the use of combinationcapecitabine and temozolomide in patients with advanced pNET. We summarize their results and discuss the role of thisregimen in treatment algorithms for metastatic pNET.