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Advances in the treatment of gastroenteropancreatic neuroendocrine tumors.

Kunz PL, Fisher GA - Clin Exp Gastroenterol (2010)

Bottom Line: Biotherapies such as somatostatin analogs and interferon can decrease the secretion of peptides and inhibit their end-organ effects.A second objective for treatment of unresectable GEP-NETs is limiting tumor growth.In particular, angiogenesis inhibitors, tyrosine kinase inhibitors, and mTOR inhibitors have shown early promising results.

View Article: PubMed Central - PubMed

Affiliation: Stanford University Medical Center, CA, USA.

ABSTRACT
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a rare and heterogeneous class of neoplasms. While surgical resection is the mainstay of treatment, non-surgical therapies play a role in the setting of unresectable and metastatic disease. The goals of medical therapy are directed both at alleviating symptoms of peptide release and shrinking tumor mass. Biotherapies such as somatostatin analogs and interferon can decrease the secretion of peptides and inhibit their end-organ effects. A second objective for treatment of unresectable GEP-NETs is limiting tumor growth. Options for limiting tumor growth include somatostatin analogs, systemic chemotherapy, locoregional therapies, ionizing radiation, external beam radiation, and newer targeted agents. In particular, angiogenesis inhibitors, tyrosine kinase inhibitors, and mTOR inhibitors have shown early promising results. The rarity of these tumors, their resistance to standard chemotherapy, and the excellent performance status of most of these patients, make a strong argument for consideration of novel therapeutic trials.

No MeSH data available.


Related in: MedlinePlus

Response to bevacizumab, capecitabine, and oxaliplatin.On left are two cuts demonstrating the characteristic appearance of enhancing liver lesions (note that aorta is bright white signifying arterial phase scan) in a patient with a pancreatic neuroendocrine tumor. On right are corresponding cuts after 2 cycles (6 weeks) of bevacizumab, capecitabine, and oxaliplatin demonstrating marked decrease in vascularity of lesions.
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f1-ceg-3-079: Response to bevacizumab, capecitabine, and oxaliplatin.On left are two cuts demonstrating the characteristic appearance of enhancing liver lesions (note that aorta is bright white signifying arterial phase scan) in a patient with a pancreatic neuroendocrine tumor. On right are corresponding cuts after 2 cycles (6 weeks) of bevacizumab, capecitabine, and oxaliplatin demonstrating marked decrease in vascularity of lesions.

Mentions: Data demonstrating marked reduction in perfusion of tumors after administration of angiogenesis inhibitors (see Figure 1) may provide a valuable surrogate marker of response in a disease for which radiographic responses are rare and the slow growth rate of most of these tumors makes assessment of progression-free survival problematic.31


Advances in the treatment of gastroenteropancreatic neuroendocrine tumors.

Kunz PL, Fisher GA - Clin Exp Gastroenterol (2010)

Response to bevacizumab, capecitabine, and oxaliplatin.On left are two cuts demonstrating the characteristic appearance of enhancing liver lesions (note that aorta is bright white signifying arterial phase scan) in a patient with a pancreatic neuroendocrine tumor. On right are corresponding cuts after 2 cycles (6 weeks) of bevacizumab, capecitabine, and oxaliplatin demonstrating marked decrease in vascularity of lesions.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108662&req=5

f1-ceg-3-079: Response to bevacizumab, capecitabine, and oxaliplatin.On left are two cuts demonstrating the characteristic appearance of enhancing liver lesions (note that aorta is bright white signifying arterial phase scan) in a patient with a pancreatic neuroendocrine tumor. On right are corresponding cuts after 2 cycles (6 weeks) of bevacizumab, capecitabine, and oxaliplatin demonstrating marked decrease in vascularity of lesions.
Mentions: Data demonstrating marked reduction in perfusion of tumors after administration of angiogenesis inhibitors (see Figure 1) may provide a valuable surrogate marker of response in a disease for which radiographic responses are rare and the slow growth rate of most of these tumors makes assessment of progression-free survival problematic.31

Bottom Line: Biotherapies such as somatostatin analogs and interferon can decrease the secretion of peptides and inhibit their end-organ effects.A second objective for treatment of unresectable GEP-NETs is limiting tumor growth.In particular, angiogenesis inhibitors, tyrosine kinase inhibitors, and mTOR inhibitors have shown early promising results.

View Article: PubMed Central - PubMed

Affiliation: Stanford University Medical Center, CA, USA.

ABSTRACT
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a rare and heterogeneous class of neoplasms. While surgical resection is the mainstay of treatment, non-surgical therapies play a role in the setting of unresectable and metastatic disease. The goals of medical therapy are directed both at alleviating symptoms of peptide release and shrinking tumor mass. Biotherapies such as somatostatin analogs and interferon can decrease the secretion of peptides and inhibit their end-organ effects. A second objective for treatment of unresectable GEP-NETs is limiting tumor growth. Options for limiting tumor growth include somatostatin analogs, systemic chemotherapy, locoregional therapies, ionizing radiation, external beam radiation, and newer targeted agents. In particular, angiogenesis inhibitors, tyrosine kinase inhibitors, and mTOR inhibitors have shown early promising results. The rarity of these tumors, their resistance to standard chemotherapy, and the excellent performance status of most of these patients, make a strong argument for consideration of novel therapeutic trials.

No MeSH data available.


Related in: MedlinePlus