Division of Hematology, Oncology, and Blood and Marrow Transplantation, Neuroendocrine Tumor Program, University of Iowa Hospitals and Clinic, Iowa City, Iowa 52242, USA.
Oncology. 2012;83(3):117-27. doi: 10.1159/000339539. Epub 2012 Jul 12.
Although neuroendocrine tumors (NET) are a relatively rare malignancy, the reported incidence is increasing, and some of the current treatment options are limited in their efficacy. Standard first-line therapy for metastatic small bowel NET includes somatostatin analogs. Although these agents can provide symptom relief and can delay disease progression in many patients, ultimately, new treatments are required for patients with progressive disease. In recent years, there has been considerable interest in developing agents specifically targeted against some of the pathways known to be involved in cancer cell growth, survival and invasion. In 2011, the mammalian target of rapamycin (mTOR) inhibitor everolimus and the tyrosine kinase inhibitor sunitinib were approved for the treatment of pancreatic NET. Clinical trials evaluating novel targeted agents are ongoing, both as single agents and in combination regimens. We review the current clinical status of these potential new treatments and highlight those with particular promise for the management of well-differentiated NET.
虽然神经内分泌肿瘤（NET）是一种相对罕见的恶性肿瘤，但报告的发病率正在增加，并且目前的一些治疗选择在疗效上受到限制。转移性小肠 NET 的标准一线治疗包括生长抑素类似物。虽然这些药物可以提供症状缓解，并能在许多患者中延迟疾病进展，但对于疾病进展的患者最终需要新的治疗方法。近年来，人们对开发专门针对一些已知参与癌细胞生长、存活和侵袭的途径的药物产生了浓厚的兴趣。2011 年，雷帕霉素（mTOR）抑制剂依维莫司和酪氨酸激酶抑制剂舒尼替尼被批准用于治疗胰腺 NET。正在进行评估新型靶向药物的临床试验，包括单药治疗和联合治疗方案。我们回顾了这些潜在新治疗方法的临床现状，并强调了那些对分化良好的 NET 管理具有特别希望的方法。
