title: Therapy innovation for the treatment of pancreatic neuroendocrine tumors.
abstract: BACKGROUND
  Traditional therapeutic approaches for patients with advanced neuroendocrine tumors (NETs) have included treatment with somatostatin analogs, hepatic-directed therapies, interferon and cytotoxic chemotherapy. Current knowledge about biological behavior of pancreatic neuroendocrine tumors (pNETs) has increased in the last decade, and some studies have been conducted to translate in the clinical setting. Among several molecular agents investigated in patients with progressive pNETs, everolimus and sunitinib have been studied in large Phase III trials. Both have produced significant benefit, with improvement in progression-free survival. These results were published last year by NEJM and were updated at the ASCO Annual Meeting in June 2011.
  
  
  METHODS
  This review focuses on the potential molecular targets in pancreatic NETs in the light of recent advances. Furthermore, it summarizes the available data for targeted agents from Phase II and III trials open to patients with this tumor.
  
  
  CONCLUSIONS
  These new agents are likely to play an increasingly important role in the future management of advanced pNETs. Their use in earlier phases of the disease could improve clinical outcome, avoiding side effects of the more toxic chemotherapy. The challenge in medical treatment of pNET is to define the patients who can benefit from this innovative therapy; future research should be directed to find predictive markers for response to the targeted agent.
authors.affiliation: UOSC di Oncologia Medica, Gruppo NET Cardarelli, Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli, Napoli, Italy. nando.riccardi@alice.it
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Riccardi
authors.forename: Mimma
authors.initials: M
authors.lastname: Rizzo
authors.forename: Lucia
authors.initials: L
authors.lastname: Festino
authors.forename: Francesca
authors.initials: F
authors.lastname: Ambrosio
authors.forename: Carlo
authors.initials: C
authors.lastname: Molino
authors.forename: Generoso
authors.initials: G
authors.lastname: Uomo
authors.forename: Giacomo
authors.initials: G
authors.lastname: Cartenì
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D018358:Neuroendocrine Tumors / Q000188:drug therapy* / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D058570:TOR Serine-Threonine Kinases