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Updated: Feb 4, 2026

Human Neuroendocrine Tumor Cell Lines as a Three-Dimensional Model for the Study of Human Neuroendocrine Tumor Therapy
Published on: August 14, 2012
Role of the tumor microenvironment in digestive neuroendocrine tumors
Thomas Cuny1,2,3, Wouter de Herder1, Anne Barlier2,3
1Division Endocrinology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
Abstract:
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a group of heterogeneous tumors whose incidence increased over the past few years. Around half of patients already present with metastatic disease at the initial diagnosis. Despite extensive efforts, cytotoxic and targeted therapies have provided only limited efficacy for patients with metastatic GEP-NETs, mainly due to the development of a certain state of resistance. One factor contributing to both the failure of systemic therapies and the emergence of an aggressive tumor phenotype may be the tumor microenvironment (TME), comprising dynamic and adaptative assortment of extracellular matrix components and non-neoplastic cells, which surround the tumor niche. Accumulating evidence shows that the TME can simultaneously support both tumor growth and metastasis and contribute to a certain state of resistance to treatment. In this review, we summarize the current knowledge of the TME of GEP-NETs and discuss the current therapeutic agents that target GEP-NETs and those that could be of interest in the (near) future.
Insights
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are increasing, with many patients diagnosed with metastatic disease. The tumor microenvironment (TME) hinders treatment efficacy and promotes GEP-NETs progression.
Area of Science:
- Oncology
- Cancer Biology
- Tumor Microenvironment Research
Background:
- Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) incidence is rising, with approximately 50% of patients presenting with metastatic disease at diagnosis.
- Current cytotoxic and targeted therapies show limited efficacy in metastatic GEP-NETs due to treatment resistance.
- The tumor microenvironment (TME) is increasingly recognized as a critical factor influencing GEP-NETs progression and therapeutic resistance.
Purpose of the Study:
- To review current knowledge on the tumor microenvironment (TME) in gastroenteropancreatic neuroendocrine tumors (GEP-NETs).
- To discuss existing therapeutic agents targeting GEP-NETs.
- To explore potential future therapeutic strategies targeting the TME in GEP-NETs.
Main Methods:
- Literature review of current research on GEP-NETs and their tumor microenvironment.
- Analysis of existing therapeutic approaches for metastatic GEP-NETs.
- Exploration of emerging therapeutic targets within the TME.
Main Results:
- The TME plays a dual role in GEP-NETs, supporting tumor growth, metastasis, and treatment resistance.
- Limited efficacy of current therapies suggests a need for novel treatment strategies.
- The TME presents potential targets for future GEP-NETs therapies.
Conclusions:
- Understanding the TME is crucial for improving treatment outcomes in GEP-NETs.
- Targeting the TME offers a promising avenue for overcoming therapeutic resistance in metastatic GEP-NETs.
- Future research should focus on developing novel therapies that modulate the GEP-NETs TME.
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