Treatment personalization in gastrointestinal neuroendocrine tumors

Borga, Chiara; Businello, Gianluca; Murgioni, Sabina; Bergamo, Francesca; Martini, Chiara; Carlo, Eugenio De; Trevellin, Elisabetta; Vettor, Roberto; Fassan, Matteo

doi:10.1007/s11864-021-00825-4

Cited by 10 publications

(12 citation statements)

References 103 publications

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“…Recently, Japan approved the use of the agent in PRRT, which had already been approved by the FDA and was broadly used for the treatment of GEP NETs in Europe and in the US [ 72 , 83 ]. The efficacy of immune checkpoint inhibitors for GEP-NENs remains controversial; meanwhile, some clinical trials are ongoing [ 83 , 84 ]. Although these novel and personalized therapeutic options are expected to improve the prognosis of patients with GEP-NENs, their application in clinical settings is still limited.…”

Section: Discussionmentioning

confidence: 99%

Update on Epidemiology, Diagnosis, and Biomarkers in Gastroenteropancreatic Neuroendocrine Neoplasms

Takayanagi

Cho

Machida

et al. 2022

Cancers

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are a heterogeneous group of malignancies that originate from the diffuse neuroendocrine cell system of the pancreas and gastrointestinal tract and have increasingly increased in number over the decades. GEP-NENs are roughly classified into well-differentiated neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas; it is essential to understand the pathological classification according to the mitotic count and Ki67 proliferation index. In addition, with the advent of molecular-targeted drugs and somatostatin analogs and advances in endoscopic and surgical treatments, the multidisciplinary treatment of GEP-NENs has made great progress. In the management of GEP-NENs, accurate diagnosis is key for the proper selection among these diversified treatment methods. The evaluation of hormone-producing ability, diagnostic imaging, and histological diagnosis is central. Advances in the study of the genetic landscape have led to deeper understanding of tumor biology; it has also become possible to identify druggable mutations and predict therapeutic effects. Liquid biopsy, based on blood mRNA expression for GEP-NENs, has been developed, and is useful not only for early detection but also for assessing minimal residual disease after surgery and prediction of therapeutic effects. This review outlines the updates and future prospects of the epidemiology, diagnosis, and management of GEP-NENs.

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Section: Discussionmentioning

confidence: 99%

Update on Epidemiology, Diagnosis, and Biomarkers in Gastroenteropancreatic Neuroendocrine Neoplasms

Takayanagi

Cho

Machida

et al. 2022

Cancers

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“…A recent CLARINET FORTE phase 2 clinical trial further supports the clinical benefit of the SSA lanreotide autogel (LAN), which led to significantly improved progression-free survival (PFS) and disease control rate in patients with GEN-NETs, especially in cases with a Ki67 index ≤ 10%[ 86 ]. In addition to SSA[ 87 ], novel therapeutic approaches, including PRRT, targeted therapy, and immunotherapy, have demonstrated promising clinical benefits[ 88 - 90 ].…”

Section: Novel Therapeutic Approachesmentioning

confidence: 99%

New insights in diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms

Yin¹,

Wu²,

Lai³

2022

WJG

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) are rare epithelial neoplasms derived from pluripotent endocrine cells along the gastrointestinal tract and pancreas. GEP-NENs are classified into well-differentiated neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas. Despite overlapping morphological features, GEP-NENs vary in molecular biology, epigenetic, clinical behavior, treatment response, and prognosis features and remain an unmet clinical challenge. In this review, we introduce recent updates on the histopathologic classification, including the tumor grading and staging system, molecular genetics, and systemic evaluation of the diagnosis and treatment of GEP-NENs at different anatomic sites, together with some insights into the diagnosis of challenging and unusual cases. We also discuss the application of novel therapeutic approaches for GEP-NENs, including peptide receptor radionuclide therapy, targeted therapy, and immunotherapy with immune checkpoint inhibitors. These findings will help improve patient care with precise diagnosis and individualized treatment of patients with GEP-NENs.

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“…ICIs have been demonstrated to be effective against melanoma ( 61 , 62 ) and non-small-cell lung cancer ( 63 ) and so on. Emerging evidence has shown the possibility of targeting the tumor immune microenvironment as novel therapeutic option for NENs ( 64 , 65 ). Besides PD-L1/L2 expression has been identified in GEP-NETs ( 66 ), in metastatic GEP-NENs, the expression of PD-L1 is associated with high-grade NET ( 67 ) and has both predictive and prognostic value for survival of patients ( 66 , 68 ).…”

Section: Standard and Promising Therapies For Unresectable/recurrent Gep-nets And Necsmentioning

confidence: 99%

“…Some evidence suggests that tumor mutation burden (TMB) may be a useful biomarker to select patients who could respond to immunotherapy, independently from the microsatellite instability status of the tumor ( 64 ). According to the subanalysis of the Keynote158 study, this tendency is thought to be similar for GEP-NET ( 75 ).…”

Section: Standard and Promising Therapies For Unresectable/recurrent Gep-nets And Necsmentioning

confidence: 99%

Current status of medical treatment for gastroenteropancreatic neuroendocrine neoplasms and future perspectives

Hijioka¹,

Morizane²,

Ikeda

et al. 2021

Japanese Journal of Clinical Oncology

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Neuroendocrine neoplasms (NENs) constitute a heterogeneous group of tumors. In this review, we summarize the results of various clinical trials that have been conducted to investigate the efficacy and safety of various therapeutic options for NENs. Based on the encouraging results obtained from these trials, various therapeutic options have been established for the treatment of NENs, including somatostatin analogs (SSAs), molecularly targeted drugs and cytotoxic agents. In addition, peptide receptor radionucleotide therapy has recently been evaluated for the treatment of various NENs. We also discuss the approach for selecting the appropriate drugs and sequence of treatment with the various drug classes, as recommended by different treatment guidelines. Finally, we discuss the scope for future research in this field, especially into the merits of combination therapy with molecularly targeted drugs plus SSAs, along with ongoing studies.

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Treatment personalization in gastrointestinal neuroendocrine tumors

Cited by 10 publications

References 103 publications

Update on Epidemiology, Diagnosis, and Biomarkers in Gastroenteropancreatic Neuroendocrine Neoplasms

Update on Epidemiology, Diagnosis, and Biomarkers in Gastroenteropancreatic Neuroendocrine Neoplasms

New insights in diagnosis and treatment of gastroenteropancreatic neuroendocrine neoplasms

Current status of medical treatment for gastroenteropancreatic neuroendocrine neoplasms and future perspectives

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