title: Evaluating digestive neuroendocrine tumor progression and therapeutic responses in the era of targeted therapies: state of the art.
abstract: Well-differentiated neuroendocrine tumors (NETs) are a group of heterogeneous rare tumors. They are often slow-growing and patients can have very long survival, even at the metastatic stage. The evaluation of tumor progression and therapeutic responses is currently based on Response Evaluation Criteria In Solid Tumors v1.1 (RECIST) criteria. As for other malignancies, RECIST criteria are being reexamined for NETs in the era of targeted therapies because tumor response to targeted therapies is rarely associated with shrinkage, as opposed to prolonged progression-free survival. Therefore, size-based criteria no longer seem to be suitable to the assessment of NET progression and therapeutic responses, especially considering targeted therapies. New imaging criteria, combining morphological and functional techniques, have proven relevant for other malignancies treated with targeted therapies. To date, such studies have rarely been conducted on NETs. Moreover, optimizing the management of NET patients also requires considering clinical, biological, and pathological aspects of tumor evolution. Our objectives herein were to comprehensively review current knowledge on the assessment of tumor progression and early prediction of therapeutic responses and to broaden the outlook on well-differentiated NETs, in the era of targeted therapies.
authors.affiliation: Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Avenue du Général Koenig, 51092 Reims Cedex, France Department of Radiology, Institut Gustave-Roussy, Villejuif, France Department of Radiology, Beaujon University Hospital, Clichy, France Department of Pathology, Edouard-Herriot Hospital, Lyon, France Integrated Research Cancer Institute in Villejuif, UMR 8081, Paris-Sud University, Institut Gustave-Roussy, Villejuif, France Department of Nuclear Medicine, Beaujon University Hospital, Clichy, France Department of Medical Oncology, René-Huguenin Hospital, Institut Curie, Saint-Cloud, France Department of Digestive Oncology, Institut Claudius-Regaud and Toulouse University Hospital, Toulouse, France Department of Nuclear Medicine, Institut Claudius-Regaud, Toulouse, France Department of Biology and Pathology, Lille University Hospital, Lille, France.
authors.forename: Louis
authors.initials: L
authors.lastname: de Mestier
authors.forename: Clarisse
authors.initials: C
authors.lastname: Dromain
authors.forename: Gaspard
authors.initials: G
authors.lastname: d'Assignies
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Scoazec
authors.forename: Nathalie
authors.initials: N
authors.lastname: Lassau
authors.forename: Rachida
authors.initials: R
authors.lastname: Lebtahi
authors.forename: Hedia
authors.initials: H
authors.lastname: Brixi
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mitry
authors.forename: Rosine
authors.initials: R
authors.lastname: Guimbaud
authors.forename: Frédéric
authors.initials: F
authors.lastname: Courbon
authors.forename: Michèle
authors.initials: M
authors.lastname: d'Herbomez
authors.forename: Guillaume
authors.initials: G
authors.lastname: Cadiot
mesh_terms: D000818:Animals; D018450:Disease Progression; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D058990:Molecular Targeted Therapy; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000628:therapy*
keywords: CT scan; MRI; biomarker; contrast-enhanced imaging; evaluation; isotopic imaging; neuroendocrine tumors; prognosis; progression; response; targeted therapies; ultrasonography