Papaxoinis George, Syrigos Kostas, Saif Muhammad Wasif
Christie Hospital NHS Foundation Trust, Manchester, M204BX, UK.
Oncology Unit, Third Department of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece.
Discov Med. 2016 May;21(117):391-402.
Low-intermediate grade neuroendocrine tumors (NETs) are usually slow-growing cancers with a clinical course spanning few to several years managed with active surveillance, locoregional treatments, or somatostain analogs. At some point in their natural history, they develop resistance to these treatments and become more aggressive. Chemotherapy offers only limited therapeutic benefit and any evidence is based on small trials or retrospective studies. The significant progress in molecular biology shed light on the significant role of PI3K/Akt/mTOR pathway and angiogenesis in NETs, while the success of everolimus and sunitinib in landmark clinical trials opened new avenues in the discovery of effective treatments. Ongoing and planned pivotal studies testing newer agents targeting other pathways are underway. In addition to providing better treatment options, these drugs also broadened our understanding of the biology of these tumors. Biomarkers are eagerly needed with the scope of personalizing future treatment.
低中级神经内分泌肿瘤（NETs）通常是生长缓慢的癌症，临床病程从数年到数年不等，可通过积极监测、局部区域治疗或生长抑素类似物进行管理。在其自然病程的某个阶段，它们会对这些治疗产生耐药性，并变得更具侵袭性。化疗仅提供有限的治疗益处，且任何证据均基于小型试验或回顾性研究。分子生物学的重大进展揭示了PI3K/Akt/mTOR通路和血管生成在NETs中的重要作用，而依维莫司和舒尼替尼在具有里程碑意义的临床试验中的成功为发现有效治疗方法开辟了新途径。正在进行和计划中的关键研究正在测试针对其他通路的新型药物。除了提供更好的治疗选择外，这些药物还拓宽了我们对这些肿瘤生物学的理解。迫切需要生物标志物以实现未来治疗的个性化。
