Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, 19111, USA.
Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Curr Treat Options Oncol. 2020 Oct 7;21(12):96. doi: 10.1007/s11864-020-00794-0.
Ongoing advances in our understanding of neuroendocrine tumor (NET) biology, genetics, and immunology, will continue to expand the availability of targeted therapies, thus improving the outcomes of patients. Well-differentiated neuroendocrine tumors (NETs) are grouped into pancreatic and non-pancreatic NETs (includes GI and thoracic NETs) for treatment considerations (Fig. 1). For panNETs, initial therapy is driven by the need of radiographic response, and targeted agents are typically reserved for second and third line based on the toxicity profile. Treatment options for non-pancreatic NETs are also expanding and while SSAs are the typical first-line option, everolimus and PRRT both remain approved therapies for future lines, and VEGF TKIs are showing promising results in research settings. Sequencing these agents and best time to incorporate peptide receptor radio therapy into the management algorithm remains an unmet need.
神经内分泌肿瘤 (NET) 生物学、遗传学和免疫学的研究不断取得进展，这将继续扩大靶向治疗的应用范围，从而改善患者的预后。分化良好的神经内分泌肿瘤 (NET) 分为胰腺和非胰腺 NET（包括胃肠道和胸部 NET），以便进行治疗考虑（图 1）。对于胰腺 NET，初始治疗取决于影像学反应的需要，而靶向药物通常根据毒性特征保留在二线和三线治疗中。非胰腺 NET 的治疗选择也在不断扩大，虽然 SSAs 是典型的一线选择，但 everolimus 和 PRRT 均为未来治疗线的获批治疗药物，VEGF TKIs 在研究环境中也显示出良好的效果。对这些药物进行排序，以及将肽受体放射性治疗纳入管理算法的最佳时间仍然是未满足的需求。
