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Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists01:28

Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists

Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy.  SP binds and activates these...

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Functioning neuroendocrine tumors (NET): Minimum requirements for a NET specialist.

F Spada1, R E Rossi2, R Modica3

  • 1Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IEO, IRCCS, Milan, Italy.

Cancer Treatment Reviews
|March 2, 2025
PubMed
Summary
This summary is machine-generated.

Functioning neuroendocrine tumors (f-NETs) management is complex. This review highlights the need for multidisciplinary care and improved diagnostic tools for these challenging hormonal syndromes.

Keywords:
Carcinoid syndromeFunctioning neuroendocrine tumorsGastrinomaGlucagonomaInsulinomaParaneoplastic syndromes

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Area of Science:

  • Endocrinology
  • Oncology
  • Gastroenterology

Background:

  • Functioning neuroendocrine tumors (f-NETs) are rare but challenging NETs impacting patient survival and quality of life.
  • Paraneoplastic syndromes (PNS) can complicate NETs management due to ectopic hormone production.
  • Limited dedicated guidelines exist for f-NETs and PNS management.

Purpose of the Study:

  • To review the literature on functioning neuroendocrine tumors (f-NETs).
  • To propose a clinical tool for improved diagnosis and management of f-NETs.
  • To enhance understanding and treatment of paraneoplastic syndromes associated with NETs.

Main Methods:

  • A narrative review of existing literature on functioning neuroendocrine tumors (f-NETs).

Main Results:

  • Common f-NETs include insulinomas, gastrinomas, and carcinoid syndrome (CS)-associated NETs.
  • Symptoms often overlap with other disorders, necessitating multidisciplinary management.
  • Somatostatin analogs (SSAs) are first-line treatment; other therapies include surgery, liver-directed, targeted, and radionuclide therapies.
  • Paraneoplastic syndromes can complicate clinical course and treatment response.

Conclusions:

  • Management of hormonal syndromes from f-NETs requires a multidisciplinary approach.
  • Establishing minimal requirements for NET specialists is crucial for diagnosis and treatment.
  • Increased awareness, understanding of pathogenesis, and improved management strategies for f-NETs are needed.