Choosing the best systemic treatment sequence for control of tumour growth in gastro-enteropancreatic neuroendocrine tumours (GEP-NETs): what is the recent evidence?

Maria Passhak, Mairead G. Mcnamara, Richard A. Hubner, Irit Ben-Aharon, Juan W. Valle

Research output: Contribution to journalArticlepeer-review

Abstract

Gastro-enterohepatic neuroendocrine tumours (GEP-NETs) represent a rare and highly heterogeneous entity with increasing incidence. Based on the results obtained from several trials performed in the last decade, various therapeutic options have been established for the treatment of patients with GEP-NETs. The options include somatostatin analogues, targeted therapies (sunitinib and everolimus), chemotherapy (with temozolomide or streptozocin-based regimens), and peptide receptor radionuclide therapy. The treatment choice is influenced by various clinico-pathological factors including tumour grade and morphology, the primary mass location, hormone secretion, the volume of the disease and the rate of tumour growth, as well as patient comorbidities and performance status.
In this review, the efficacy and safety of treatment options for patients with GEP-NETs is discussed and the evidence to inform the best sequence of available therapies to control tumour growth, prolong patient survival, and to lower potential toxicity, while maintaining patient quality of life is explored.
Original languageEnglish
JournalBest Practice and Research: Clinical Endocrinology and Metabolism
Publication statusAccepted/In press - 23 Oct 2023

Keywords

  • Gastro–enteropancreatic neuroendocrine tumours
  • treatment sequence
  • chemotherapy
  • PRRT
  • targeted therapy
  • somatostatin analog

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