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Published on: February 19, 2022

Medical treatment of gastrinomas

Christoph J Auernhammer1, Burkhard Göke

  • 1Department of Internal Medicine II, Hospital of the University of Munich, Ludwig-Maximilians-University Munich, Munich-Grosshadern, Germany.

Wiener Klinische Wochenschrift
|November 7, 2007
PubMed

Insights

This review covers medical treatments for gastrinomas (neuroendocrine tumors) when surgery isn't curative. Key therapies include proton-pump inhibitors for symptom relief and targeted treatments for metastatic disease.

Area of Science:

  • Gastroenterology
  • Oncology
  • Endocrinology

Background:

  • Gastrinomas are neuroendocrine tumors of the gastroenteropancreatic system.
  • Surgery is the primary treatment but often not curative.
  • This review focuses on medical management for non-curable gastrinoma.

Purpose of the Study:

  • To review current medical treatment strategies for surgically non-curable gastrinoma.
  • To outline therapeutic options based on tumor differentiation and metastatic status.

Main Methods:

  • Literature review of medical treatment strategies for gastrinoma.
  • Analysis of symptomatic and disease-directed therapies.

Main Results:

  • Proton-pump inhibitors effectively manage symptoms in Zollinger-Ellison syndrome.
  • For well-differentiated neuroendocrine tumors (G1/G2), somatostatin analogues are first-line, chemotherapy (streptozotocin/doxorubicin/5-FU) is second-line.
  • For poorly differentiated neuroendocrine tumors (G3), etoposide/cisplatin chemotherapy is an option.

Conclusions:

  • Medical therapy is crucial for managing non-curable gastrinoma, improving quality of life, and treating metastatic disease.
  • Treatment strategies vary based on tumor grade and progression.
  • Future therapies may involve novel somatostatin analogues, angiogenesis inhibitors, and kinase inhibitors.

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