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Published on: August 2, 2022
[Current developments in the treatment of neuroendocrine tumors]
Barbara Kiesewetter-Wiederkehr1, Philipp Melhorn2, Christian Scheuba3
1Klinische Abteilung für Onkologie, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Waehringer Guertel 18-20, 1090, Wien, Österreich. barbara.kiesewetter@meduniwien.ac.at.
Background:
Well-differentiated neuroendocrine tumors (NET) are rare malignancies that are clinically very heterogeneous. Accordingly, their treatment is also complex and dependent on various factors. With currently available systemic therapies, the prognosis is often favorable.
Objectives:
This article aims to provide an overview of current treatment strategies for NET, addressing the most important NET locations.
Methods:
The current European guidelines and further relevant literature on the treatment of NET were reviewed for this purpose.
Results:
The therapeutic spectrum for NET is extremely broad: For NET of the stomach/duodenum, appendix, and rectum, endoscopic or surgical resection is often sufficient, and metastatic tumors are rare. NET of the pancreas, small intestine and lung should also undergo potentially curative resection in the early stages. In the metastatic stage, locoregional treatments such as surgery and liver tumor embolization play a role. Major advances have been made in drug therapy, with somatostatin analogs (octreotide and lanreotide), an mTOR inhibitor (everolimus), and a tyrosine kinase inhibitor (sunitinib) being widely used. Peptide receptor radionuclide therapy (PRRT) is also an invaluable option. In some cases, classic chemotherapy is indicated.
Conclusions:
Many effective therapies are now available for NET. It is important to select the right therapy at the right time for each patient through interdisciplinary management.
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