New treatment options with cytotoxic agents in neuroendocrine tumours.
There are numerous treatment options for patients with advanced digestive neuroendocrine tumours (NETs). Medical treatment includes systemic chemotherapies, targeted therapies, somatostatin analogs, liver-directed therapies such as (chemo)embolization or thermoablation, and peptide receptor radionuclide therapy. Cytotoxic chemotherapies can help control tumour progression in patients with non-resectable tumours and may improve symptoms by reducing tumour bulk. In addition, tumour response is usually greater than that obtained with targeted therapies. This should be taken into consideration in neoadjuvant strategies. Efficacy of temozolomide depends on the O(6) methylguanine DNA methyl transferase status, and thus, this drug will likely have to be considered in the future in patients with a favourable enzyme profile. Because numerous treatment options are available for patients with advanced digestive NETs, and thanks to their long survival, successive drugs should be used. Careful attention should be paid to the adverse events in order to maintain the quality of life in these patients who have with a long life expectancy.
Service de Gastroenterologie-Pancreatologie, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII), Clichy, France. pascal.hammel@bjn.aphp.fr
Pascal
P
Hammel
Olivia
O
Hentic
Cindy
C
Neuzillet
Sandrine
S
Faivre
Eric
E
Raymond
Philippe
P
Ruszniewski
D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D002276:Carcinoid Tumor / Q000188:drug therapy* / Q000473:pathology; D002986:Clinical Trials as Topic; D003603:Cytotoxins / Q000627:therapeutic use; D015254:DNA Modification Methylases / Q000378:metabolism; D045643:DNA Repair Enzymes / Q000378:metabolism; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D008495:Medical Oncology / Q000379:methods; D018358:Neuroendocrine Tumors / Q000188:drug therapy* / Q000473:pathology*; D011788:Quality of Life; D013311:Streptozocin / Q000627:therapeutic use; D000077204:Temozolomide; D016896:Treatment Outcome; D025521:Tumor Suppressor Proteins / Q000378:metabolism
D000903:Antibiotics, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D003603:Cytotoxins; D025521:Tumor Suppressor Proteins; D013311:Streptozocin; D003606:Dacarbazine; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes; D000077204:Temozolomide