Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3)

Sørbye, Halfdan; Baudin, Éric; Borbath, Ivan; Caplin, Martyn; Chen, Jie; Ćwikła, Jarosław B.; Frilling, Andrea; Grossman, Ashley; Kaltsas, Gregory; Scarpa, Aldo; Welin, Staffan; Garcia-Carbonero, Rocío

doi:10.1159/000493318

Cited by 66 publications

(50 citation statements)

References 76 publications

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“…Morphological classification in NEC currently is challenging. There still were cases considered to be ambiguous during a morphological review assessment . It is unclear whether SCNEC should be treated differently from non‐SCNEC.…”

Section: Discussionmentioning

confidence: 99%

Etoposide and cisplatin versus irinotecan and cisplatin as the first‐line therapy for patients with advanced, poorly differentiated gastroenteropancreatic neuroendocrine carcinoma: A randomized phase 2 study

Zhang

et al. 2020

Cancer

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BACKGROUND: Platinum-based chemotherapy is recommended for the treatment of advanced gastroenteropancreatic neuroendocrine carcinoma (GEP-NEC). The objective of the current phase 2 study was to compare the efficacy and toxicity between etoposide and cisplatin (EP) and irinotecan and cisplatin (IP) as first-line treatment in patients with advanced GEP-NEC. METHODS: Patients with advanced, poorly differentiated GEP-NEC randomly were assigned to receive EP or IP. The primary endpoint was the objective response rate (ORR). The secondary endpoints were progression-free survival, overall survival, and toxicities. RESULTS: The planned size of the study population was 144 patients, but enrollment was terminated early at 66 patients because the premature analysis found similar responses in the 2 treatment arms. The ORRs of the EP and IP arms both were 42.4% (14 of 33 patients). The efficacy was similar for small cell NEC with EP or IP (63.2% and 61.5%, respectively; P = .61), whereas that of IP was slightly better in patients with non-small cell NEC (30% vs 14.3%; P = .42). The median progression-free survival was 6.4 months and 5.8 months, respectively, for the EP and IP arms (P = .81), and the median overall survival was 11.3 months and 10.2 months, respectively, for the EP and IP arms (P = .37). The incidence of grade 3/4 neutropenia was significantly higher in the EP arm compared with the IP arm (45.4% vs 12.1%; P = .002). Nonhematological toxicity was relatively mild and more frequent in the IP arm compared with the EP arm (54.5% vs 18.2%; P = .001). No toxicity-related deaths were reported. CONCLUSIONS: The results of the current study demonstrated that IP is not inferior to EP, with comparable efficacy for poorly differentiated NEC of the digestive system. In addition, both regimens appear to be well tolerated with diverse toxicity profiles.

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Section: Discussionmentioning

confidence: 99%

Etoposide and cisplatin versus irinotecan and cisplatin as the first‐line therapy for patients with advanced, poorly differentiated gastroenteropancreatic neuroendocrine carcinoma: A randomized phase 2 study

Zhang

et al. 2020

Cancer

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“…Bei lokalisiertem oder regional begrenztem GEP-NET G3 und NEC wird ein operatives Vorgehen angestrebt, ggf. mit adjuvanter Therapie [81]. Ausnahme könnten die Ösophagus-NEC darstellen.…”

Section: Knochenmarkreserve Des Patienten Ausreichend Hoch Seinunclassified

Gastroenteropankreatische neuroendokrine Neoplasien – Heterogenität, Management und Perspektiven der Versorgung und Forschung

Luley

Gebauer

et al. 2020

Internist

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Medizin aktuell Tab. 1 Einteilung der GEP-NEN laut WHO-Klassifikation. (Lloyd et al. [57], Nagtegaal et al. [70]) NET NEC MiNEN G1 G2 G3 Anteil Ki67-positiver Tumorzellen (%) <3 3-20 >20 Variabel Variabel Mitosen/10 HPF <2 2-20 >20 Variabel Variabel NET-Morphologie Erhalten Erhalten Erhalten Fehlt Erhalten oder fehlend GEP-NEN gastroenteropankreatische neuroendokrine Neoplasien, HPF "high-power field" (Hauptgesichtsfeld), MiNEN "mixed neuroendocrine-nonneuroendocrine neoplasm" (gemischte neuroendokrine/nichtneuroendokrine Neoplasien), NEC neuroendokrine Karzinome, NET neuroendokrine Tumoren, WHO World Health Organization

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“…In any case, the Ki67 proliferation index should be recorded in the histopathological report, as there is evidence that it is directly related to patients' survival. 13,16 Finally, the recognition and characterisation of the non-neuroendocrine component of MiNENs frequently relies both on the morphological examination of the lesion and on the negativity for general neuroendocrine markers. In a few sites and clinical contexts, however, the use of immunostaining may give important information.…”

Section: Introductionmentioning

confidence: 99%

Looking into digestive mixed neuroendocrine – nonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors

Uccella

Rosa

2020

Histopathology

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Looking into digestive mixed neuroendocrinenonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors Mixed neuroendocrinenonneuroendocrine neoplasms (MiNENs) of the digestive system represent a challenge for both pathologists and clinicians. Their nomenclature has changed several times, and their diagnostic criteria, classification and clinical behaviour have been matter of debate over the years. Although several attempts have been made to elucidate the pathogenesis and biology of MiNENs, some issues remain open. This review will provide: a historical background that helps in understanding the evolution of the concept and nomenclature of mixed neoplasms; a revision of the knowledge on this topic, including molecular aspects, to give the reader a comprehensive and practical overview on this challenging field of pathology; a focus on the diagnostic criteria and on the determination of prognostic and predictive factors; and a description of the different tumour types in the different sites of origin.

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Unmet Needs in High-Grade Gastroenteropancreatic Neuroendocrine Neoplasms (WHO G3)

Cited by 66 publications

References 76 publications

Etoposide and cisplatin versus irinotecan and cisplatin as the first‐line therapy for patients with advanced, poorly differentiated gastroenteropancreatic neuroendocrine carcinoma: A randomized phase 2 study

Etoposide and cisplatin versus irinotecan and cisplatin as the first‐line therapy for patients with advanced, poorly differentiated gastroenteropancreatic neuroendocrine carcinoma: A randomized phase 2 study

Gastroenteropankreatische neuroendokrine Neoplasien – Heterogenität, Management und Perspektiven der Versorgung und Forschung

Looking into digestive mixed neuroendocrine – nonneuroendocrine neoplasms: subtypes, prognosis, and predictive factors

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