{"title":"[Systemic treatment of patients with metastatic neuroendocrine Neoplasia].","authors":"Anja Rinke, Friederike Eilsberger","doi":"10.1055/a-2173-0588","DOIUrl":null,"url":null,"abstract":"<p><p>Due to the complexity and heterogeneity of metastatic NEN an interdisciplinary expert team should be involved in an individualized treatment strategy. SSA is the mainstay of antisecretory treatment in most functioning tumors. In antiproliferative intention SSA are first line treatment in receptor positive low proliferative NET. In intestinal metastatic disease PRRT is best established second line treatment. Further options are Everolimus (labeled) and tyrosine kinase inhibitors (off-label). Everolimus is the only approved drug for antiproliferative treatment in patients with metastatic lung NET, whereas in pancreatic NET more therapeutic options are available (SSA, chemotherapy, PRRT, Sunitinib, Everolimus) without a standard of best sequence. In patients with metastatic NEC standard first line treatment (platinum + etoposide) has not changed for decades and new treatment options for this fatal disease are urgently needed. Benefit of immunotherapy is limited to a small subset of patients - new combinations are under investigation. This review summarizes the standard of care, criteria of treatment selection and new developments for systemic therapy in patients with metastatic NEN.</p>","PeriodicalId":93975,"journal":{"name":"Deutsche medizinische Wochenschrift (1946)","volume":"149 15","pages":"879-886"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Deutsche medizinische Wochenschrift (1946)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/a-2173-0588","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/16 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Due to the complexity and heterogeneity of metastatic NEN an interdisciplinary expert team should be involved in an individualized treatment strategy. SSA is the mainstay of antisecretory treatment in most functioning tumors. In antiproliferative intention SSA are first line treatment in receptor positive low proliferative NET. In intestinal metastatic disease PRRT is best established second line treatment. Further options are Everolimus (labeled) and tyrosine kinase inhibitors (off-label). Everolimus is the only approved drug for antiproliferative treatment in patients with metastatic lung NET, whereas in pancreatic NET more therapeutic options are available (SSA, chemotherapy, PRRT, Sunitinib, Everolimus) without a standard of best sequence. In patients with metastatic NEC standard first line treatment (platinum + etoposide) has not changed for decades and new treatment options for this fatal disease are urgently needed. Benefit of immunotherapy is limited to a small subset of patients - new combinations are under investigation. This review summarizes the standard of care, criteria of treatment selection and new developments for systemic therapy in patients with metastatic NEN.
由于转移性鼻咽癌的复杂性和异质性,跨学科专家团队应参与个体化治疗策略。在大多数功能性肿瘤中,SSA 是抗分泌治疗的主要手段。对于受体阳性的低增殖性NET,抗增殖意向SSA是一线治疗手段。对于肠道转移性疾病,PRRT 是最佳的二线治疗方法。其他选择包括依维莫司(标签内)和酪氨酸激酶抑制剂(标签外)。埃维莫司是唯一获准用于转移性肺癌患者抗增生治疗的药物,而胰腺癌患者有更多的治疗选择(SSA、化疗、PRRT、舒尼替尼、埃维莫司),但没有最佳治疗顺序标准。对于转移性 NEC 患者,标准的一线治疗方法(铂类+依托泊苷)几十年来从未改变过,这种致命疾病迫切需要新的治疗方案。免疫疗法的益处仅限于一小部分患者--新的组合疗法正在研究中。本综述总结了转移性 NEN 患者的治疗标准、治疗选择标准和全身治疗的新进展。