Current Treatment Options in Gastroenteropancreatic Neuroendocrine Carcinoma.

Autor: Thomas KEH; Department of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana, USA., Voros BA; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.; Neuroendocrine Tumor Clinic, Ochsner Medical Center-Kenner, Kenner, Louisiana, USA., Boudreaux JP; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.; Neuroendocrine Tumor Clinic, Ochsner Medical Center-Kenner, Kenner, Louisiana, USA., Thiagarajan R; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.; Neuroendocrine Tumor Clinic, Ochsner Medical Center-Kenner, Kenner, Louisiana, USA., Woltering EA; Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.; Neuroendocrine Tumor Clinic, Ochsner Medical Center-Kenner, Kenner, Louisiana, USA., Ramirez RA; Division of Hematology/Oncology, Department of Internal Medicine, Ochsner Medical Center, New Orleans, Louisiana, USA robert.ramirez@ochsner.org.; Neuroendocrine Tumor Clinic, Ochsner Medical Center-Kenner, Kenner, Louisiana, USA.
Jazyk: angličtina
Zdroj: The oncologist [Oncologist] 2019 Aug; Vol. 24 (8), pp. 1076-1088. Date of Electronic Publication: 2019 Jan 11.
DOI: 10.1634/theoncologist.2018-0604
Abstrakt: Poorly differentiated gastroenteropancreatic neuroendocrine carcinomas (GEPNECs) are a rare neoplasm with a bleak prognosis. Currently there are little prospective data available for optimal treatment. This review discusses the current available regimens and the future direction for the treatment of GEPNECs. Treatment plans for GEPNECs are often adapted from those devised for small cell lung cancer; however, differences in these malignancies exist, and GEPNECs require their own treatment paradigms. As such, current first-line treatment for GEPNECs is platinum-based chemotherapy with etoposide. Studies show that response rate and overall survival remain comparable between cisplatin and carboplatin versus etoposide and irinotecan; however, prognosis remains poor, and more efficacious therapy is needed to treat this malignancy. Additional first-line and second-line treatment options beyond platinum-based chemotherapy have also been investigated and may offer further treatment options, but again with suboptimal outcomes. Recent U.S. Food and Drug Administration approval of peptide receptor radionuclide therapy in low- and intermediate-grade neuroendocrine tumors may open the door for further research in its usefulness in GEPNECs. Additionally, the availability of checkpoint inhibitors lends promise to the treatment of GEPNECs. This review highlights the lack of large, prospective studies that focus on the treatment of GEPNECs. There is a need for randomized control trials to elucidate optimal treatment regimens specific to this malignancy. IMPLICATIONS FOR PRACTICE: There are limited data available for the treatment of poorly differentiated gastroenteropancreatic neuroendocrine carcinomas (GEPNECs) because of the rarity of this malignancy. Much of the treatment regimens used in practice today come from research in small cell lung cancer. Given the poor prognosis of GEPNECs, it is necessary to have treatment paradigms specific to this malignancy. The aim of this literature review is to summarize the available first- and second-line GEPNEC therapy, outline future treatments, and highlight the vast gap in the literature.
Competing Interests: Disclosures of potential conflicts of interest may be found at the end of this article.
(© AlphaMed Press 2019.)
Databáze: MEDLINE
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