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Advances in the systemic treatment of pancreatic neuroendocrine tumors
1Hacettepe University Institute of Oncology, Department of Medical Oncology, Sıhhiye, 06100 Ankara, Turkey. syalcin@hacettepe.edu.tr
Abstract:
Constituting about 1-2% of all tumors of the pancreas, pancreatic neuroendocrine tumors (PNETs) are a subgroup of gastroenetropancreatic neuroendocrine tumors (GEP-NETs) with distinct tumor genetics, biology, and clinicopathological features. Surgical resection is amenable only in a minority of the cases so systemic therapies are considered in most of them. The goals of medical treatment are to control the associated symptoms and signs of the specific tumors and to shrink the tumor mass. Somatostatin analogues can, not only decrease the secretion of peptides and inhibit their functions but also stop tumor growth. Other medical options for limiting tumor growth include interferon, systemic chemotherapy, and targeted therapies including, angiogenesis inhibitors, epidermal growth factor inhibitors, and mTOR inhibitors. Newer agents are tested and the treatment options expected to increase in the near future. Meanwhile optimal use of the available therapeutic strategies is critical.
Insights
Pancreatic neuroendocrine tumors (PNETs) are rare gastroenetropancreatic neuroendocrine tumors. Systemic therapies aim to control symptoms and shrink tumors, with somatostatin analogues being a key treatment option.
Area of Science:
- Oncology
- Gastroenterology
- Endocrinology
Background:
- Pancreatic neuroendocrine tumors (PNETs) represent 1-2% of pancreatic tumors and are a distinct subtype of gastroenetropancreatic neuroendocrine tumors (GEP-NETs).
- PNETs exhibit unique genetic, biological, and clinicopathological characteristics.
- Surgical resection is only feasible for a minority of patients, necessitating systemic therapies for most.
Purpose of the Study:
- To review the current systemic treatment strategies for PNETs.
- To highlight the goals of medical management, including symptom control and tumor mass reduction.
- To discuss the role of various therapeutic agents in managing PNETs.
Main Methods:
- Review of existing literature on PNET treatment modalities.
- Analysis of the mechanisms of action for different systemic therapies.
- Discussion of emerging treatment options and future directions.
Main Results:
- Somatostatin analogues effectively decrease peptide secretion, inhibit functions, and inhibit tumor growth.
- Other systemic options include interferon, chemotherapy, and targeted therapies (angiogenesis inhibitors, epidermal growth factor inhibitors, mTOR inhibitors).
- Newer agents are under investigation, suggesting an expanding therapeutic landscape.
Conclusions:
- Optimal utilization of current therapeutic strategies is crucial for managing PNETs.
- The treatment of PNETs requires a multidisciplinary approach.
- Future research will likely expand the available treatment options for PNETs.
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