Mukherjee Sunanda Biswas, Shanker Rachyl M, Madigan James P, Sadowski Samira M
Neuroendocrine Cancer Therapy Section, Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Cancers (Basel). 2025 Jun 21;17(13):2080. doi: 10.3390/cancers17132080.
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a varied group of tumors that originate from neuroendocrine cells found throughout the gastrointestinal tract. These tumors encompass a broad spectrum of biological behaviors, ranging from slow-growing, well-differentiated neuroendocrine tumors (GEP-NETs) to aggressive and poorly differentiated neuroendocrine carcinomas (GEP-NECs), complicating their accurate classification and effective treatment. While advances in molecular research have refined our understanding of these tumors, their complexity, unpredictable progression, and differential response to therapies remain major clinical hurdles. A significant clinical challenge is the accurate grading and diagnosis of GEP-NENs, which is traditionally reliant on subjective methods. However, innovative technologies, such as artificial intelligence-based diagnostics, multi-omics approaches, and precision oncology, are now offering solutions for more precise and reliable classification. Meanwhile, emerging therapies aiming to activate the immune response or modify the tumor environment present promising avenues for improved outcomes. Realizing the full potential of these advances will require a thoughtful integration of molecular insights with standardized diagnostic practices and evolving therapeutic strategies, ensuring that progress in research meaningfully informs and enhances patient care across diverse clinical settings. This review discusses new advancements and explores future directions toward personalized and effective treatments for GEP-NENs.
胃肠胰神经内分泌肿瘤（GEP-NENs）是一组起源于整个胃肠道神经内分泌细胞的多种肿瘤。这些肿瘤涵盖了广泛的生物学行为，从生长缓慢、分化良好的神经内分泌肿瘤（GEP-NETs）到侵袭性强、分化差的神经内分泌癌（GEP-NECs），这使得它们的准确分类和有效治疗变得复杂。虽然分子研究的进展深化了我们对这些肿瘤的理解，但它们的复杂性、不可预测的进展以及对治疗的不同反应仍然是主要的临床障碍。一个重大的临床挑战是GEP-NENs的准确分级和诊断，传统上这依赖于主观方法。然而，基于人工智能的诊断、多组学方法和精准肿瘤学等创新技术，现在为更精确和可靠的分类提供了解决方案。与此同时，旨在激活免疫反应或改变肿瘤微环境的新兴疗法为改善治疗结果提供了有前景的途径。要充分发挥这些进展的潜力，需要将分子见解与标准化诊断实践和不断发展的治疗策略进行深思熟虑的整合，确保研究进展能切实为不同临床环境下的患者护理提供信息并提升护理质量。本综述讨论了新进展，并探索了针对GEP-NENs的个性化有效治疗的未来方向。
