Update in the Therapy of Advanced Neuroendocrine Tumors

Uri, Inbal; Avniel-Polak, Shani; Gross, David J.; Grozinsky‐Glasberg, Simona

doi:10.1007/s11864-017-0514-9

Cited by 18 publications

(22 citation statements)

References 73 publications

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“…A variety of therapeutic strategies, such as somatostatin analogues, molecular therapies, peptide receptor radionuclide therapy (PRRT), and chemotherapy regimens, have been investigated and approved in inoperable or metastatic G1/G2 NET patients [11]. However, standard cytotoxic agents commonly used in clinical practice Immunohistochemistry (IHC) studies with antibodies directed against chromogranin, synaptophysin, oestrogen receptor (ER), progesterone receptor (PgR), and HER2/neu, were carried out.…”

Section: Discussionmentioning

confidence: 99%

Capecitabine plus temozolomide in well- or moderately-differentiated primary atypical neuroendocrine tumours — single-centre experience of two cases

Salvia

Brizzi

Muratori

et al. 2019

Endokrynologia Polska

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Introduction: Neuroendocrine neoplasms (NENs) are a rare and heterogeneous group of tumours, with a variety of primary origins and variable aggressiveness. NENs with an atypical primary origin, such as breast and retroperitoneal NENs, are extremely rare. As a consequence, an established diagnostic and therapeutic strategy in this particular subgroup is lacking. The combination of capecitabine and temozolomide, called CAPTEM regimen, has produced promising response rates in patients with grade 1 or 2 neuroendocrine tumours of multiple origins. Case presentation: The first is a case of a 68-year-old woman with a metastatic primary breast neuroendocrine tumour, treated with cisplatin plus etoposide as first line, followed by CAV scheme (cyclophosphamide, doxorubicin, and vincristine), and subsequently treated, in third line with the CAPTEM regimen, obtaining radiological response and good tolerance. The second is the case of a 66-year-old woman affected by a metastatic primitive retroperitoneal NET G2. The patient progressed after a somatostatin analogue-based first line, whereas the CAPTEM regimen led to a partial and durable response with a favourable safety profile. Conclusions: CAPTEM chemotherapy has been shown to be an active and safe therapeutic option in advanced, metastatic G1/2 atypical primary NENs.

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Section: Discussionmentioning

confidence: 99%

Capecitabine plus temozolomide in well- or moderately-differentiated primary atypical neuroendocrine tumours — single-centre experience of two cases

Salvia

Brizzi

Muratori

et al. 2019

Endokrynologia Polska

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“…PRRT is another type of GEP-NEN treatment based on "a combination of somatostatin analogues with yttrium or lutetium isotopes, and the cytotoxic factor is the ionizing radiation of the isotope" [51]. Radionuclide therapy seems to be a good method when patients intensely accumulate the marker at each neoplasm site of a small size, which can be used to achieve total remission, or at least a reduction in the neoplasm's mass [52]. In the presence of liver metastases by GEP-NEN, as a form of palliative treatment, radiofrequency ablation (RFA), trans-arterial embolization (TAE), and trans-arterial chemoembolization (TACE) can be offered [53].…”

Section: The Treatment Of Neuroendocrine Neoplasmsmentioning

confidence: 99%

The Neuroendocrine Neoplasms of the Digestive Tract: Diagnosis, Treatment and Nutrition

et al. 2020

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Nuroendocrine neoplasms (NENs) are a group of rare neoplasms originating from dispersed neuroendocrine cells, mainly of the digestive and respiratory tract, showing characteristic histology and immunoprofile contributing to classification of NENs. Some NENs have the ability to produce biogenic amines and peptide hormones, which may be associated with clinical syndromes like, e.g., the carcinoid syndrome caused by unmetabolized overproduced serotonin, hypoglycemic syndrome in case of insulinoma, or Zollinger-Ellison syndrome accompanying gastrinoma. Diagnostics for these include ultrasound with endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography/computed tomography (PET/CT). Different nuclear medicine procedures can also be used, like somatostatin analogues scintigraphy (SRS) and 68Ga-Dota-Peptide PET/CT, as well as biochemical methods to determine the level of general neuroendocrine markers, such as chromogranin A (CgA), 5-hydroxyindolacetic acid (5-HIAA), synaptopfysin and cell type-specific peptide hormones, and neurotransmitters like gastrin, insulin, serotonin, and histamine. NENs influence the whole organism by modulating metabolism. The treatment options for neuroendocrine neoplasms include surgery, somatostatin analogue therapy, radionuclide therapy, chemotherapy, molecular targeted therapies, alpha-interferon therapy, and inhibitors of serotonin production. In the case of hypersensitivity to biogenic amines, a diet that limits the main sources of amines should be used. The symptoms are usually connected with histamine, tyramine and putrescine. Exogenic sources of histamine are products that take a long time to mature and ferment. Patients with a genetic insufficiency of the diamine oxidase enzyme (DAO), and those that take medicine belonging to the group of monoamine oxidases (MAO), are particularly susceptible to the negative effects of amines. Diet plays an important role in the initiation, promotion, and progression of cancers. As a result of the illness, the consumption of some nutrients can be reduced, leading to nutritional deficiencies and resulting in malnutrition. Changes in metabolism may lead to cachexia in some patients suffering from NENs. The aim of this narrative review was to advance the knowledge in this area, and to determine possibilities related to dietary support. The authors also paid attention to role of biogenic amines in the treatment of patients with NENs. We can use this information to better understand nutritional issues faced by patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), and to help inform the development of screening tools and clinical practice guidelines.

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“…25 Furthermore, recently published case series report promising results of immunotherapy while multiple ongoing phase II trials study the activity of immune checkpoint inhibitors in NENs. 26,27…”

Section: Introductionmentioning

confidence: 99%

Current best practice in the management of neuroendocrine tumors

Tsoli

Chatzellis

Koumarianou

et al. 2018

Therapeutic Advances in Endocrinology

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Neuroendocrine neoplasms are rare tumors that display marked heterogeneity with varying natural history, biological behavior, response to therapy and prognosis. Their management is complex, particularly as a number of them may be associated with a secretory syndrome and involve a variety of options. A number of factors such as proliferation rate, degree of differentiation, functionality and extent of the disease are mostly utilized to tailor treatment accordingly, ideally in the context of a multidisciplinary team. In addition, a number of relevant scientific societies have published therapeutic guidelines in an attempt to direct and promote evidence-based treatment. Surgery remains the treatment of choice with an intention to cure while it may also be recommended in some cases of metastatic disease and difficult to control secretory syndromes. Long-acting somatostatin analogs constitute the main treatment for the majority of functioning tumors, whereas specific evolving agents such as telotristat may be used for the control of carcinoid syndrome and related sequelae. In patients with advanced disease not amenable to surgical resection, treatment options include locoregional therapies, long-acting somatostatin analogs, molecular targeted agents, radionuclides, chemotherapy and recently immunotherapy, alone or in combination. However, the ideal time of treatment initiation, sequence of administration of different therapies and identification of robust prognostic markers to select the most appropriate treatment for each individual patient still need to be defined.

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Update in the Therapy of Advanced Neuroendocrine Tumors

Cited by 18 publications

References 73 publications

Capecitabine plus temozolomide in well- or moderately-differentiated primary atypical neuroendocrine tumours — single-centre experience of two cases

Capecitabine plus temozolomide in well- or moderately-differentiated primary atypical neuroendocrine tumours — single-centre experience of two cases

The Neuroendocrine Neoplasms of the Digestive Tract: Diagnosis, Treatment and Nutrition

Current best practice in the management of neuroendocrine tumors

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