Systemic therapies for advanced gastroenteropancreatic neuroendocrine tumors.

Systemic therapies for advanced gastroenteropancreatic neuroendocrine tumors. Expert Rev Endocrinol Metab. 2016 Jul;11(4):311-327 Authors: Patel D, Chan D, Cehic G, Pavlakis N, Price TJ Abstract INTRODUCTION: Neuroendocrine tumors are a heterogeneous group of malignancies, characterised by production of hormones and vasoactive peptides. The incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NET) is rising, and they have the highest prevalence amongst upper gastro-intestinal tumors. Diagnosis remains challenging due to wide variations in presentation and slow onset of symptoms. A multi-disciplinary approach is vital in appropriately managing the diverse spectrum of GEP-NET. Areas covered: Investigations in GEP-NET and biomarkers are described. Moreover, all available therapeutic options for GEP-NET including surgery, somatostatin analogues, targeted agents, Peptide Receptor Radionuclide Therapy and chemotherapy are also discussed. Expert commentary: The landscape of management has changed significantly in the last decade as a result of many practice-changing clinical trials. Long- acting somatostatin analogues are used not only for symptom control but also for their anti-proliferative effect. Targeted agents, such as everolimus and sunitinib, have improved PFS in GEP-NET. The recently presented NETTER-1 trial confirms the place of peptide receptor radionuclide treatment (PRRT) in treating NET. While chemotherapy remained a...
Source: Expert Review of Endocrinology and Metabolism - Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research