Neuroendocrine Tumours - Medical Treatment

作者：Pavel Marianne^*

来源：Viszeralmedizin, 2010, 26(4): 276-282.

DOI：10.1159/000322123

• Neuroendocrine tumours
• Somatostatin analogues
• Interferon-alpha
• Chemotherapy
• Molecular targeted therapy

Neuroendocrine Tumours - Medical Treatment Effective medical agents include somatostatin analogues (SSA), interferon-alpha, cytotoxics, and molecular targeted therapies. Due to the rarity and heterogeneity of the disease the knowledge of the impact of these strategies on the anti-proliferative treatment of neuroendocrine tumours (NET) is limited and no clearly defined treatment algorithms exist. The choice of medical therapy in metastatic non-resectable NET is primarily directed by the histological differentiation and functionality of the tumour as well as the extent of the disease. Surgical and local ablative procedures may complement medical treatment especially in functional active NET. Therapeutic decision is often individualized and best taken by an experienced multidisciplinary clinician group within a tumour board. Nevertheless some principal rules are applicable to specific patient groups: SSA are the first-line treatment in functional active NET whereas in proliferating pancreatic NET streptozotocin-based chemotherapy and in poorly differentiated NET cisplatin and etoposide represent established therapies. Temozolomide-based regimens are promising in pancreatic NET and warrant further clinical investigations. In contrast, slowly progressing midgut NET are not responsive to chemotherapy. Recent placebo-controlled trials underline the value of SSA in the anti-proliferative treatment of midgut NET and the efficacy of everolimus and sunitinib in progressive pancreatic NET. These drugs will change the treatment algorithm in the future.

• 出版日期2010