Advanced neuroendocrine tumours of the small intestine and pancreas: clinical developments, controversies, and future strategies

Christoph J Auernhammer; Christine Spitzweg; Martin K Angele; Stefan Boeck; Ashley Grossman; Svenja Nölting; Harun Ilhan; Thomas Knösel; Julia Mayerle; Martin Reincke; Peter Bartenstein

doi:10.1016/S2213-8587(17)30401-1

Advanced neuroendocrine tumours of the small intestine and pancreas: clinical developments, controversies, and future strategies

Lancet Diabetes Endocrinol. 2018 May;6(5):404-415. doi: 10.1016/S2213-8587(17)30401-1. Epub 2017 Dec 8.

Authors

Affiliations

¹ Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of Internal Medicine 4, Ludwig-Maximilians-University of Munich, Munich, Germany. Electronic address: [email protected].
² Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of Internal Medicine 4, Ludwig-Maximilians-University of Munich, Munich, Germany.
³ Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Ludwig-Maximilians-University of Munich, Munich, Germany.
⁴ Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of Internal Medicine 3, Ludwig-Maximilians-University of Munich, Munich, Germany.
⁵ Neuroendocrine Tumour Centre, Royal Free Hospital, London, UK.
⁶ Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
⁷ Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany.
⁸ Interdisciplinary Center of Neuroendocrine Tumours of the GastroEnteroPancreatic System, Ludwig-Maximilians-University of Munich, Munich, Germany; Department of Internal Medicine 2, Klinikum der Universitaet Muenchen, Ludwig-Maximilians-University of Munich, Munich, Germany.

PMID: 29229497
DOI: 10.1016/S2213-8587(17)30401-1

Abstract

In this Review, we discuss clinical developments and controversies in the treatment of neuroendocrine tumours (NETs) that are relevant for clinicians and clinical researchers. We describe advances in genetics, blood-based biomarkers, functional imaging, and systemic therapy of advanced NETs and discuss results of recent phase 3 studies, systemic treatment of advanced disease with peptide receptor radionuclide therapy, biotherapy, chemotherapy, and molecularly targeted therapy, and the potential role of immunotherapy in the treatment of NETs. Suggested treatment algorithms for NETs of ileal or jejunal origin and of pancreatic origin are presented.

Publication types

Review

MeSH terms

Biomarkers, Tumor / blood
Clinical Trials, Phase III as Topic
Epigenesis, Genetic
Humans
Intestinal Neoplasms* / diagnosis
Intestinal Neoplasms* / therapy
Neuroendocrine Tumors* / diagnosis
Neuroendocrine Tumors* / therapy
Pancreatic Neoplasms* / diagnosis
Pancreatic Neoplasms* / therapy
Treatment Outcome

Substances

Biomarkers, Tumor