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Digestive neuroendocrine tumors (DNET): the era of targeted therapies

Tarek Boussaha1, Philippe Rougier, Julien Taieb

  • 1Service d'hépatogastroentérologie, Groupement Hospitalier Pitié-Salpêtrière, Paris, France.

Clinics and Research in Hepatology and Gastroenterology
|April 9, 2013
PubMed

Insights

Digestive neuroendocrine tumors (DNETs) are increasingly common. New targeted therapies like sunitinib and everolimus offer new options for advanced DNETs, though their precise role requires further study.

Area of Science:

  • Oncology
  • Gastroenterology
  • Endocrinology

Background:

  • Digestive neuroendocrine tumors (DNETs) are a significant and growing cause of digestive cancers.
  • Therapeutic strategies for DNETs are tailored to tumor location, grade, and hormonal activity.
  • Well-differentiated DNETs (WHO grades 1 and 2) have specific therapeutic axes including somatostatin analogs, anti-angiogenesis, and mTOR pathway targeting.

Purpose of the Study:

  • To review current and emerging therapeutic options for well-differentiated DNETs.
  • To highlight the impact of recent phase III trials on treatment strategies.
  • To discuss the potential role of targeted therapies in the management of DNETs.

Main Methods:

  • Review of major randomized phase III clinical trials.
  • Analysis of therapeutic axes for well-differentiated DNETs.
  • Evaluation of targeted therapies such as sunitinib and everolimus.

Main Results:

  • Sunitinib and everolimus are established options for advanced, progressive pancreatic NETs.
  • Everolimus demonstrated effectiveness in small intestine NETs, though not reaching statistical significance in all criteria.
  • Somatostatin analogs remain important for slowly progressive metastatic DNETs with limited hepatic invasion.

Conclusions:

  • Targeted therapies represent significant advancements in managing well-differentiated DNETs.
  • Further research is needed to define the optimal place of these novel agents within the broader DNET treatment landscape.
  • Comparative studies are essential to elucidate the precise role of targeted therapies against established treatments like chemotherapy and embolization.

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