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Medical Management of Pancreatic Neuroendocrine Tumors: Current and Future Therapy

Jennifer A Chan1, Matthew H Kulke1

  • 1Department of Medical Oncology, Dana-Farber Cancer Institute, Dana 1220, 450 Brookline Avenue, Boston, MA 02215, USA.

Surgical Oncology Clinics of North America
|March 26, 2016
PubMed

Insights

For advanced pancreatic neuroendocrine tumors (NETs), early resection offers a cure. Management of metastatic NETs requires a multidisciplinary approach, utilizing surgery, liver-directed, and systemic therapies like somatostatin analogs.

Area of Science:

  • Oncology
  • Gastroenterology
  • Endocrinology

Background:

  • Pancreatic neuroendocrine tumors (NETs) are rare neoplasms with variable clinical behavior.
  • Early-stage diagnosis and surgical resection offer curative potential for pancreatic NETs.
  • Metastatic disease often precludes curative surgical options, necessitating alternative management strategies.

Purpose of the Study:

  • To review current management options for advanced pancreatic neuroendocrine tumors (NETs).
  • To emphasize the importance of a multidisciplinary approach in treating heterogeneous NET presentations.
  • To highlight available systemic therapies and areas for future research.

Main Methods:

  • Literature review of therapeutic options for advanced pancreatic NETs.
  • Synthesis of data on surgical, liver-directed, and systemic treatments.
  • Discussion of disease heterogeneity and the need for personalized treatment strategies.

Main Results:

  • Multiple therapeutic modalities exist for advanced pancreatic NETs, including surgery, liver-directed therapies, and systemic agents.
  • Somatostatin analogs, sunitinib, everolimus, and alkylating agents are established systemic treatment options.
  • A multidisciplinary approach is crucial due to the diverse biology and presentation of pancreatic NETs.

Conclusions:

  • Effective management of advanced pancreatic NETs relies on a combination of treatment modalities.
  • Further research is needed to optimize treatment sequencing, combinations, and identify response predictors.
  • Personalized therapeutic strategies are essential for improving outcomes in patients with advanced pancreatic NETs.
Keywords:
EverolimusPancreatic neuroendocrine tumorSomatostatin analogueSunitinibTemozolomidemTOR

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