Department of Hematology-Oncology, St. Francis Hospital and Medical Center, Hartford, CT 06105, USA.
Expert Opin Pharmacother. 2012 Mar;13(4):461-71. doi: 10.1517/14656566.2012.656089. Epub 2012 Feb 1.
Several chemotherapy agents and combinations have proven effective in the therapy of advanced enteropancreatic neuroendocrine tumors (EP-NETs). However, their toxicity can be significant. Recent understanding of the molecular mechanisms of these tumors, especially the central role of tumor angiogenesis, has led to the identification of new therapeutic targets and agents directed at the molecular level.
This paper gives a comprehensive evaluation of the existing therapeutic armamentarium for EP-NETs. Narrated in a historical perspective, this review analyzes the available information on traditional chemotherapy agents, interferon-α and somatostatin analogs, as well as newer therapies and experimental agents.
Despite recent advances, a curative approach for metastatic EP-NETs is yet to be discovered. To date, sunitinib and everolimus have been shown to impact progression-free survival only in pancreatic NETs, and the duration of this benefit has not yet been established. Further research is necessary to determine whether a combination of these drugs, either together or with other therapies, may yield superior outcomes. Moreover, sequential use of these agents should be explored in an attempt to improve survival. Efficacy of a variety of experimental agents is also being tested in clinical trials.
几种化疗药物和联合方案已被证明对晚期肠胰神经内分泌肿瘤（EP-NET）的治疗有效。然而，其毒性可能很大。最近对这些肿瘤的分子机制的理解，特别是肿瘤血管生成的核心作用，导致了新的治疗靶点和针对分子水平的药物的确定。
本文全面评估了 EP-NET 现有的治疗方案。本文从历史角度叙述，分析了传统化疗药物、干扰素-α和生长抑素类似物的现有信息，以及更新的治疗方法和实验药物。
尽管最近取得了进展，但仍未发现转移性 EP-NET 的治愈方法。迄今为止，舒尼替尼和依维莫司仅显示在胰腺 NET 中影响无进展生存期，并且尚未确定这种获益的持续时间。需要进一步研究以确定这些药物的组合（无论是联合使用还是与其他疗法联合使用）是否可能产生更好的结果。此外，应探索这些药物的序贯使用，以试图提高生存率。各种实验药物的疗效也正在临床试验中进行测试。
