Medical Treatment of Gastrointestinal Neuroendocrine Neoplasms

被引:9
作者
Tsoli, Marina [1 ]
Alexandraki, Krystallenia [1 ]
Xanthopoulos, Christos [1 ]
Kassi, Eva [1 ,2 ]
Kaltsas, Gregory [1 ]
机构
[1] Natl & Kapodistrian Univ Athens, Dept Propaedeut & Internal Med 1, Athens, Greece
[2] Natl & Kapodistrian Univ Athens, Dept Biol Chem, Athens, Greece
关键词
neuroendocrine tumour; somatostatin analogues; radionuclides; targeted treatment; carcinoid syndrome; ENETS CONSENSUS GUIDELINES; CARCINOID-SYNDROME; PHASE-II; SYSTEMIC THERAPY; OCTREOTIDE LAR; TUMORS; MANAGEMENT; EVEROLIMUS; MULTICENTER; CHEMOTHERAPY;
D O I
10.1055/a-1110-7251
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Neuroendocrine neoplasms (NENs) are rare tumours that arise mainly in the gastrointestinal or pulmonary system. Most NENs are well-differentiated and may obtain prolonged survival besides the presence of metastatic disease; however, a subset (poorly differentiated NENs) may display a truly aggressive behaviour exhibiting a poor prognosis. The recently developed classification systems along with advances in functional imaging have helped stratify patients to the administration of appropriate therapeutic options. Surgery is the mainstay of treatment of NENs, but in recent decades there has been a considerable evolution of medical treatments that are used for locally advanced or metastatic disease not amenable to surgical resection. Long acting somatostatin analogues are the main therapeutic modality for patients with functioning and well-differentiated low grade NENs exhibiting symptomatic control and mainly stabilisation of tumour growth. Other systemic treatments include chemotherapy, molecular targeted agents, interferon-alpha, peptide receptor radionuclide therapy (PRRT), and immunotherapy. In addition, new agents such as telotristat may be used for the control of symptoms of carcinoid syndrome. The choice and/or sequence of therapeutic agents should be individualized according to tumour origin and differentiation, disease burden, presence of clinical symptoms and patients' performance status in the context of a multidisciplinary approach. Recent advances in the molecular pathogenesis of NENs set the field for a more personalised treatment approach.
引用
收藏
页码:614 / 620
页数:7
相关论文
共 74 条
[1]   Poorly-differentiated endocrine carcinomas of midgut and hindgut origin [J].
Ahlman, Hakan ;
Nilsson, Ola ;
McNicol, Anne M. ;
Ruszniewski, Philippe ;
Niederle, Bruno ;
Ricke, Jens ;
Jensen, Robert ;
Kos-Kudla, Beata ;
Oberg, Kjell ;
O'Connor, Juan M. ;
Pavel, Marianne E. ;
Vullierme, Marie-Pierre .
NEUROENDOCRINOLOGY, 2008, 87 (01) :40-46
[2]   Endocrinological Toxicity Secondary to Treatment of Gastroenteropancreatic Neuroendocrine Neoplasms (GEP-NENs) [J].
Alexandraki, Krystallenia I. ;
Daskalakis, Kosmas ;
Tsoli, Marina ;
Grossman, Ashley B. ;
Kaltsas, Gregory A. .
TRENDS IN ENDOCRINOLOGY AND METABOLISM, 2020, 31 (03) :239-255
[3]   Chemotherapy in NETs: When and how [J].
Angelousi, Anna ;
Kaltsas, Gregory ;
Koumarianou, Anna ;
Weickert, Martin O. ;
Grossman, Ashley .
REVIEWS IN ENDOCRINE & METABOLIC DISORDERS, 2017, 18 (04) :485-497
[4]   Sequential Everolimus and Sunitinib Treatment in Pancreatic Metastatic Well-Differentiated Neuroendocrine Tumours Resistant to Prior Treatments [J].
Angelousi, Anna ;
Kamp, Kimberly ;
Kaltsatou, Maria ;
O'Toole, Dermot ;
Kaltsas, Gregory ;
de Herder, Wouter .
NEUROENDOCRINOLOGY, 2017, 105 (04) :394-402
[5]   Advanced neuroendocrine tumours of the small intestine and pancreas: clinical developments, controversies, and future strategies [J].
Auernhammer, Christoph J. ;
Spitzweg, Christine ;
Angele, Martin K. ;
Boeck, Stefan ;
Grossman, Ashley ;
Nolting, Svenja ;
Ilhan, Harun ;
Knosel, Thomas ;
Mayerle, Julia ;
Reincke, Martin ;
Bartenstein, Peter .
LANCET DIABETES & ENDOCRINOLOGY, 2018, 6 (05) :404-415
[6]   The High-grade (WHO G3) Pancreatic Neuroendocrine Tumor Category Is Morphologically and Biologically Heterogenous and Includes Both Well Differentiated and Poorly Differentiated Neoplasms [J].
Basturk, Olca ;
Yang, Zhaohai ;
Tang, Laura H. ;
Hruban, Ralph H. ;
Adsay, Volkan ;
McCall, Chad M. ;
Krasinskas, Alyssa M. ;
Jang, Kee-Taek ;
Frankel, Wendy L. ;
Balci, Serdar ;
Sigel, Carlie ;
Klimstra, David S. .
AMERICAN JOURNAL OF SURGICAL PATHOLOGY, 2015, 39 (05) :683-690
[7]  
Baum Richard P, 2018, Oncotarget, V9, P16932, DOI 10.18632/oncotarget.24524
[8]   Long-term tolerability of PRRT in 807 patients with neuroendocrine tumours: the value and limitations of clinical factors [J].
Bodei, Lisa ;
Kidd, Mark ;
Paganelli, Giovanni ;
Grana, Chiara M. ;
Drozdov, Ignat ;
Cremonesi, Marta ;
Lepensky, Christopher ;
Kwekkeboom, Dik J. ;
Baum, Richard P. ;
Krenning, Eric P. ;
Modlin, Irvin M. .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2015, 42 (01) :5-19
[9]   Progress in the Treatment of Neuroendocrine Tumors [J].
Chan, Jennifer A. ;
Kulke, Matthew H. .
CURRENT ONCOLOGY REPORTS, 2009, 11 (03) :193-199
[10]   Activity and Safety of Standard and Prolonged Capecitabine/Temozolomide Administration in Patients with Advanced Neuroendocrine Neoplasms [J].
Chatzellis, Eleftherios ;
Angelousi, Anna ;
Daskalakis, Kosmas ;
Tsoli, Marina ;
Alexandraki, Krystallenia I. ;
Wachula, Ewa ;
Meirovitz, Amichay ;
Maimon, Ofra ;
Grozinsky-Glasberg, Simona ;
Gross, David ;
Kos-Kudla, Beata ;
Koumarianou, Anna ;
Kaltsas, Gregory .
NEUROENDOCRINOLOGY, 2019, 109 (04) :333-345