Sequential treatment in disseminated well-and intermediate-differentiated pancreatic neuroendocrine tumors:Common sense or low rationale?

作     者：Enrique Grande 

作者机构：Department of Medical OncologyRamón y Cajal University Hospital 

出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)

年 卷 期：2016年第7卷第2期

页      面：149-154页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Carcinoids Everolimus Neuroendocrine tumors Pancreas Overcoming resistance Sequentialtreatment Sunitinib 

摘      要：Fortunately,the landscape of the systemic treatment for grade 1 and 2 pancreatic neuroendocrine tumors has changed in the last decade with at least four different alternatives approved in the ***,somatostatin analogues,sunitinib and everolimus remind valid options according to the most referenced international ***,and although this is something done in the routine practice,there is a lack of evidence for the use of any of these strategies after failure to the ***,further sequential alternatives in third or fourth line have never been tested *** need for a better understanding of the rationale to sequence different systemic options is even greater in non-pancreatic neuroendocrine tumors since available therapies are *** strategies in other solid tumors have led to a clear improvement in overall *** is also believed to occur in neuroendocrine tumors but no clear data on it has been delivered *** postulate that the different mode of action of the systemic options available for the treatment of neuroendocrine tumors may avoid the complete resistance of one option after the other and that sequential use of these agents will be translated into a longer overall survival of *** and randomized trials that seek for the activity of drugs after failure to another systemic alternatives are highly needed in this field of neuroendocrine tumors.