A new era for the systemic therapy of neuroendocrine tumors

Jennifer R Eads1, Neal J Meropol

  • 1University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.

The Oncologist
|February 24, 2012
PubMed

Insights

Neuroendocrine tumors, including carcinoids and pancreatic types, are increasingly diagnosed. Targeted therapies like sunitinib and everolimus show promise in altering disease progression, offering new hope for patients.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Neuroendocrine tumors (NETs), including carcinoids and pancreatic NETs, are rising in incidence.
  • Most patients present with advanced disease, including lymph node metastasis or distant spread.
  • Understanding the molecular drivers of NETs has revealed key pathways for therapeutic intervention.

Purpose of the Study:

  • To review the fundamental biology of neuroendocrine tumors.
  • To discuss current and emerging systemic therapeutic strategies for NETs.
  • To highlight recent advances in targeted therapy for NETs.

Main Methods:

  • Review of existing literature on neuroendocrine tumor biology and systemic therapies.
  • Analysis of early data on cytotoxic agents.
  • Evaluation of recent phase III clinical trial data for targeted therapies.

Main Results:

  • Pharmacologic inhibition of the vascular endothelial growth factor (VEGF) pathway with sunitinib demonstrates efficacy.
  • Targeting the mammalian target of rapamycin (mTOR) pathway with everolimus has shown positive outcomes.
  • Phase III studies suggest these targeted agents can alter the natural history of NETs.

Conclusions:

  • Targeted therapies targeting VEGF and mTOR pathways represent significant advances in NET management.
  • Sunitinib and everolimus show potential to change the standard of care for patients with advanced NETs.
  • These successes pave the way for continued innovation in neuroendocrine tumor treatment.

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