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[Metastatic neuroendocrine neoplasms. Non-surgical treatment strategies]
1Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, Germany. marianne.pavel@charite.de
Abstract:
The clinical presentation of neuroendocrine neoplasms (NEN) varies depending on the site of origin, functional activity, histological differentiation and tumor growth behavior. Therapeutic strategies aim to improve the symptoms of clinical syndromes related to the secretion of amines and peptides, inhibit tumor growth and prevent complications. Novel molecular targeted drug therapies offer new treatment options in addition to established therapies, such as somatostatin analogs and chemotherapy. The precise positioning of these drugs and of peptide receptor radionuclide therapy still needs to be defined. In general, the different medical treatments are used in a sequential way and are in part combined with surgical and loco-regional/ablative procedures in a highly individualized approach. In certain clinical conditions, however, established treatment strategies are followed. This review presents the management of patients with small intestinal and pancreatic NEN with respect to the functionality and tumor grading. The use of novel targeted drug therapy is included in a therapeutic algorithm.
Insights
Neuroendocrine neoplasms (NEN) management involves personalized treatment strategies. This review details therapeutic algorithms for small intestinal and pancreatic NEN, incorporating novel targeted therapies alongside established treatments.
Area of Science:
- Oncology
- Endocrinology
- Gastroenterology
Context:
- Neuroendocrine neoplasms (NEN) present with diverse clinical manifestations based on origin, function, and tumor behavior.
- Current therapeutic strategies focus on symptom management, tumor growth inhibition, and complication prevention.
- Established treatments include somatostatin analogs and chemotherapy, with novel targeted therapies emerging.
Purpose:
- To review the management of small intestinal and pancreatic NEN.
- To integrate novel targeted drug therapies into a comprehensive therapeutic algorithm.
- To guide the precise positioning of new therapies like peptide receptor radionuclide therapy.
Summary:
- Clinical presentation of NEN is highly variable, necessitating individualized treatment approaches.
- Therapeutic strategies are often sequential, combining medical, surgical, and loco-regional/ablative procedures.
- This review outlines a management algorithm for small intestinal and pancreatic NEN, considering functionality and tumor grade, and incorporating novel targeted therapies.
Impact:
- Provides an updated therapeutic algorithm for NEN management.
- Facilitates informed clinical decision-making regarding novel targeted therapies.
- Aims to improve patient outcomes by optimizing treatment sequencing and combinations.
