Background: Based on SEER database, gastroenteropancreatic neuroendocrine tumor (GEPNET) incidence has increased 6-fold from 1 in 100,000 cases to about 6 in 100,000 cases over past 3 decades. North American Neuroendocrine Tumor Society estimates that over 100,000 GEPNET patients (pts) are currently living in the United States. A common quality of life limiting symptom for GEPNET pts is diarrhea. Excessive serotonin production, short gut syndrome, steatorrhea, bile acid colitis or intestinal bacterial overgrowth are possible causes of diarrhea in these pts. A novel amino acid based oral rehydration solution (enterade) is currently being evaluated in a Phase II clinical trial for antidiarrheal effects in post bone marrow transplant patients (NCT02919670). We conducted a pilot study of enterade in neuroendocrine tumor pts with quality of life limiting diarrhea to evaluate its antidiarrheal efficacy. Methods: Medical records of all GEPNET pts treated with enterade for symptomatic diarrhea were evaluated. Pts were treated at the Markey Cancer Center from May 2017 to January 2018. Results: Thirty-five pts were identified. One 8 Oz enterade bottle BID for 2 wks was prescribed. Antidiarrheal efficacy data were available for 23 pts. Seven pts had small bowel neuroendocrine tumors (NET), 5 had bronchial NETs, 2 had colorectal NETs, 3 had NETs of unknown primary, 3 had gastric NETS, 2 had pancreatic NETs and one had high grade neuroendocrine carcinoma of the prostate. Fourteen pts had history of prior bowel resection either for primary neuroendocrine tumor resection or debulking. Fifteen patients were receiving somatostatin analogs. Seventeen out of 23 patients reported improvement in diarrheal symptoms. Twelve out of these 17 responders reported at least a 50 percent reduction in diarrhea frequency. Conclusions: Seventeen of 23 (73.9%) GEPNET pts reported improvement in diarrhea with enterade. Twelve of 23 pts (52.2%) reported more than 50% reduction in diarrhea frequency. A prospective Phase II study of enterade in GEPNET patients with quality of life limiting diarrhea is planned.