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New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors:A glimpse into the future

World Journal of Gastrointestinal Oncology 2017年第1期9卷 4-20页

作者： Esther Una Cidon Department of Medical Oncology Royal Bournemouth HospitalBournemouthDorset BH5 2AZUnited Kingdom

Neuroendocrine(NE) gastroenteropancreatic tumors are a heterogeneous group of neoplasias arising from neuroendocrine cells of the embryological gut. Their incidence have increased significantly over the past 3 decades probably due to the improvements in imaging and diagnosis. The recent advances in molecular biology have translated into an expansion of therapeutic approaches to these patients. Somatostatin analogs, which initially were approved for control of hormonal syndromes, have recently been proven to inhibit tumor growth. Several new drugs such as antiangiogenics and others targeting mammalian target of rapamycin pathways have been approved to treat progressive pancreatic neuroendocrine tumors(NETs) although their role in nonpancreatic is still controversial. The treatment of NETs requires a coordinated multidisciplinary approach. The management of localized NETs primarily involves surgical resection followed by surveillance. However, the treatment of unresectable and/or metastatic disease may involve a combination of surgical resection, systemic therapy, and liver-directed therapies with the goal of alleviating symptoms of peptide release and controlling tumor growth. This article will review the current therapeutic strategies for metastatic gastroenteropancreatic NETs and will take a glimpse into the future approaches.

关键词： Gastroenteropancreatic neuroendocrine tumors Peptide receptor radionuclide therapy Somatostatin analogs Octreotide Transarterial chemoembolization Carcinoid syndrome setotonin Chromogranin

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