Department of Medical Oncology, Auckland City Hospital, Private Bag 92024, Auckland, New Zealand.
Gastroenterol Clin North Am. 2010 Sep;39(3):615-28. doi: 10.1016/j.gtc.2010.08.013.
Successful treatment of unresectable and metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) requires the thoughtful choice of systemic therapy as a component of a multidisciplinary therapeutic approach. The role of somatostatin analogues is established in symptom relief, but the efficacy of interferon and radiopeptide targeted therapy is not clear. The utility of a variety of tyrosine kinase and antiangiogenic agents is variable and under investigation, whereas the role of cytotoxic chemotherapy in poorly differentiated GEP-NETs is accepted. Overall, the ideal treatment of more indolent tumors is less certain. Reassessments of the GEP-NET pathology classification has provided improved logic for the role of a variety of agents, whereas the precise positioning of many new agents that target molecular pathways of angiogenesis and proliferation is under examination. This article describes the current options for systemic therapy for GEP-NETs within the framework of the current World Health Organization classification system.
成功治疗不可切除和转移性胃肠胰神经内分泌肿瘤（GEP-NETs）需要慎重选择全身治疗作为多学科治疗方法的一部分。生长抑素类似物在缓解症状方面的作用已得到确立，但干扰素和放射性肽靶向治疗的疗效尚不清楚。各种酪氨酸激酶和抗血管生成药物的作用各不相同，正在研究中，而细胞毒性化疗在分化不良的 GEP-NETs 中的作用已被接受。总体而言，更惰性肿瘤的理想治疗方法尚不确定。对 GEP-NET 病理学分类的重新评估为各种药物的作用提供了更合理的逻辑，而针对血管生成和增殖分子途径的许多新型靶向药物的准确定位正在研究中。本文在当前世界卫生组织分类系统的框架内描述了 GEP-NETs 的全身治疗的现有选择。
