Medical treatment for gastro-entero-pancreatic neuroendocrine tumours.
Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) represents a various family of rare tumours. Surgery is the first choice in GEP-NENs patients with localized disease whilst in the metastatic setting many other treatment options are available. Somatostatin analogues are indicated for symptoms control in functioning tumours. Furthermore they may be effective to inhibit tumour progression. GEP-NENs pathogenesis has been extensively studied in the last years therefore several driver mutations pathway genes have been identified as crucial factors in their tumourigenesis. GEP-NENs can over-express vascular endothelial growth factor (VEGF), basic-fibroblastic growth factor, transforming growth factor (TGF-α and -β), platelet derived growth factor (PDGF), insulin-like growth factor-1 (IGF-1) and their receptors PDGF receptor, IGF-1 receptor, epidermal growth factor receptor, VEGF receptor, and c-kit (stem cell factor receptor) that can be considered as potential targets. The availability of new targeted agents, such as everolimus and sunitinib that are effective in advanced and metastatic pancreatic neuroendocrine tumours, has provided new treatment opportunities. Many trials combing new drugs are ongoing.
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Rossana
R
Berardi
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Francesca
F
Morgese
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Mariangela
M
Torniai
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Agnese
A
Savini
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Stefano
S
Partelli
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Silvia
S
Rinaldi
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Miriam
M
Caramanti
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Consuelo
C
Ferrini
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Massimo
M
Falconi
Rossana Berardi, Francesca Morgese, Mariangela Torniai, Agnese Savini, Silvia Rinaldi, Miriam Caramanti, Consuelo Ferrini, Stefano Cascinu, Department of Medical Oncology, Università Politecnica delle Marche, 60126 Ancona, Italy.
Stefano
S
Cascinu
Chemotherapy; Everolimus; Neuroendocrine neoplasms of the gastro-entero-pancreatic system; Somatostatin analogues; Sunitinib; Targeted agents