Treatment Strategies for Metastatic Neuroendocrine Tumors of the Gastrointestinal Tract.

Opinion Statement: The therapeutic landscape of gastroenteropancreatic-neuroendocrine tumors (GEP-NETs) has evolved significantly in recent years. Current and emerging treatment options include somatostatin analogs, radiolabeled somatostatin analogs, the mTOR inhibitor everolimus, and the tyrosine k...

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Publicado en:Current Treatment Options in Oncology Vol. 18; no. 3; pp. 1 - 15
Autores principales: Cives, Mauro, Strosberg, Jonathan
Formato: research Journal Article
Publicado: Springer Nature Mar2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2017
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      pub: Springer Nature
      place: New York, New York
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        atl: Treatment Strategies for Metastatic Neuroendocrine Tumors of the Gastrointestinal Tract.
      aug:
        au:
          Cives, Mauro
          Strosberg, Jonathan
        affil: Department of Gastrointestinal Oncology , H. Lee Moffitt Cancer Center and Research Institute , 12902 Magnolia Drive Tampa 33612 USA
      sug:
        subj:
          Gastrointestinal Neoplasms Therapy
          Neuroendocrine Tumors Therapy
          Neuroendocrine Tumors Pathology
          Gastrointestinal Neoplasms Pathology
          Antineoplastic Agents Therapeutic Use
          Neoplasm Metastasis
          Clinical Trials
          Human
          Stomach Neoplasms Pathology
          Pancreatic Neoplasms Therapy
          Combined Modality Therapy
          Antineoplastic Agents Pharmacodynamics
          Drug Therapy
          Pancreatic Neoplasms Metabolism
          Neuroendocrine Tumors Metabolism
          Pancreatic Neoplasms Pathology
          Algorithms
          Intestinal Neoplasms Therapy
          Gastrointestinal Neoplasms Metabolism
          Intestinal Neoplasms Pathology
          Neoplasm Staging
          Stomach Neoplasms Therapy
          Antineoplastic Agents, Combined Adverse Effects
          Intestinal Neoplasms Metabolism
          Stomach Neoplasms Metabolism
          Treatment Outcomes
          Antineoplastic Agents, Combined Therapeutic Use
      ab: Opinion Statement: The therapeutic landscape of gastroenteropancreatic-neuroendocrine tumors (GEP-NETs) has evolved significantly in recent years. Current and emerging treatment options include somatostatin analogs, radiolabeled somatostatin analogs, the mTOR inhibitor everolimus, and the tyrosine kinase inhibitor sunitinib. Although high-quality data from phase III trials are lacking, cytotoxic agents are commonly used for the treatment of poorly differentiated neuroendocrine carcinomas and well-differentiated NETs originating in the pancreas. Hepatic-directed therapies are recommended for patients with slow-growing, liver-predominant disease but have never been compared to systemic agents. Telotristat ethyl, a novel serotonin synthesis inhibitor, has recently demonstrated efficacy in palliating diarrhea in patients with poorly controlled carcinoid syndrome. In the absence of definite predictive biomarkers, therapeutic decisions in most cases rely on clinical and pathological criteria. However, navigating the current therapeutic algorithm may be challenging, and future trials need to address several important questions: what is the best sequence of treatment? Is there a role for combination therapies in GEP-NETs? Are neoadjuvant, adjuvant, or maintenance strategies safe and effective? Do all NET patients require active treatment? What new molecular targets can be clinically exploited? A tight integration between basic and clinical research is needed to further advance the field of NETs.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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