title: Gastrointestinal neuroendocrine tumors: Searching the optimal treatment strategy--A literature review.
abstract: Neuroendocrine tumors of the gastro-entero-pancreatic system (GEP-NETs) are a heterogeneous group of neoplasms, with different malignant potential and behavior. Many treatment options are available. Surgery should be considered for localized tumors and in some selected cases of metastatic disease. Somatostatin analogs, useful for symptoms control in functioning tumors, are also effective to inhibit tumor progression in specific settings. The multi-TKI sunitinib and of the mTOR-inhibitor everolimus are efficacy for metastatic pancreatic NET (P-NET) treatment. Chemotherapy is generally used in symptomatic and progressive NETs. Peptide receptor radionuclide therapy (PRRT) should be recommended after failure of medical therapy. For tumors confined to the liver ablative techniques should be considered. Nevertheless a shared therapeutic sequence for GEP-NET treatment still does not exist. In this review, we analyzed available data trying to identify the better treatment strategy and to suggest potential therapeutic algorithms distinguishing P-NETs from gastrointestinal NETs (GI-NETs).
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy. Electronic address: r.berardi@univpm.it.
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Rinaldi
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Torniai
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Morgese
authors.affiliation: Chirurgia del Pancreas, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Partelli
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Miriam
authors.initials: M
authors.lastname: Caramanti
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Onofri
authors.affiliation: Chirurgia del Pancreas, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Polenta
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pagliaretta
authors.affiliation: Chirurgia del Pancreas, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Falconi
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000068338:Everolimus / Q000627:therapeutic use; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000556:secondary; D018358:Neuroendocrine Tumors / Q000556:secondary / Q000628:therapy*; D011758:Pyrroles / Q000627:therapeutic use; D013004:Somatostatin / Q000031:analogs & derivatives; D000077210:Sunitinib
chemical_list: D007211:Indoles; D011758:Pyrroles; D013004:Somatostatin; D000068338:Everolimus; D000077210:Sunitinib
keywords: Chemotherapy; Everolimus; Neuroendocrine tumor; Peptide receptor radionuclide therapy; Somatostatin analogs; Sunitinib; Surgery