title: New concepts in the treatment strategy of neuroendocrine tumors: the role of biotherapy.
abstract: Neuroendocrine tumors (NETs) comprise a wide range of neoplasms with diverse biological behaviors, often secreting excessive amounts of endocrine-active substances causing hormone syndromes. They are classified according to the location of the primary site and the level of histological differentiation, which has prognostic as well as therapeutic implications. Biotherapy had traditionally a significant role in the treatment of these tumors, when not amenable to surgery or local treatments. Control of carcinoid syndrome with somatostatin analogs (SSAs) significantly contributed to the improvement of the quality of life. Also, interferon has long been administered, but data were based on small studies. In contrast, PROMID and CLARINET randomized phase III trials provided the first strong evidence of significant improvement in progression-free survival in patients with gastroenteropancreatic (GEP)-NETs with octreotide and lanreotide, respectively, validating somatostatin receptors as important targets. Clinical trials testing the role of these SSAs in other primaries, e.g., lung carcinoids, as well as the efficacy of newer analogs are underway.
authors.affiliation: Christie Hospital NHS Foundation Trust, Manchester, M204BX, UK.
authors.forename: George
authors.initials: G
authors.lastname: Papaxoinis
authors.affiliation: Oncology Unit, Third Department of Medicine, University of Athens, Sotiria General Hospital, Athens, Greece.
authors.forename: Kostas
authors.initials: K
authors.lastname: Syrigos
authors.affiliation: Cancer Center, Tufts University School of Medicine, Boston, MA 02111, USA.
authors.forename: Muhammad Wasif
authors.initials: MW
authors.lastname: Saif
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001691:Biological Therapy / Q000379:methods* / Q000639:trends*; D059248:Chemoradiotherapy / Q000379:methods; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007372:Interferons / Q000627:therapeutic use; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000628:therapy*; D015282:Octreotide / Q000627:therapeutic use; D010456:Peptides, Cyclic / Q000627:therapeutic use; D011379:Prognosis; D011788:Quality of Life; D017481:Receptors, Somatostatin / Q000037:antagonists & inhibitors*; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D007155:Immunologic Factors; D010456:Peptides, Cyclic; D017481:Receptors, Somatostatin; C060347:lanreotide; D013004:Somatostatin; D007372:Interferons; D015282:Octreotide