Advances in the management and treatment of gastroenteropancreatic neuroendocrine tumors

Abstract

Gastroenteropancreatic tumors or pancreatic neuroendocrine tumors (PNETs) are relatively rare tumors, but are being recognized with increasing frequency. They comprise of secretory and nonsecretory tumors. Secretory tumors are recognized by distinct clinical syndromes, such as insulinoma and gastrinoma and nonsecretory tumors present clinically as mass effect and metastases. PNETs occur sporadically or as part of the multiple endocrine neoplasia type and von Hippel–Lindau and von Recklinghausen syndromes. Biomarkers for these tumors include peptides that are known to be secreted, and in addition chromogranins useful for detection, pancreastatin and Neurokinin A. New techniques are being developed for tumor localization, including PET scanning and peptide receptor scanning. Neuroendocrine tumors tend to be more sensitive to containment using somatostatin analogs and the currently available analog that binds the somatostatin receptors 2 and 5 will soon include agonists that also target the 1, 3 and 4 recept...