Medical management of pancreatic neuroendocrine tumors

Thierry Delaunoit, Florence Neczyporenko, Joseph Rubin, Charles Erlichman, Timothy James Hobday

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

BACKGROUND: Pancreatic neuroendocrine tumors (PNET) are rare malignancies frequently diagnosed at a late stage, with symptoms related to bulky disease. Hormonal secretion, when responsible for symptoms, permits, on the other hand, early diagnosis of the disease. Surgery remains the cornerstone of therapeutic management. However, due to advanced disease, many patients are not candidates for aggressive surgical therapy. Tumor growth control and symptom management are thus achieved through medical approaches, including somatostatin (SST) analogs, chemotherapy, interferon, and more recently, targeted therapy. The purpose of this review is to collect, examine, and analyze data available in the literature regarding contemporary therapeutic management of PNET, with emphasis on medical approaches. It also offers perspectives on the future of molecular targeted therapies in these neoplasms. However, we point out that much of the literature published to date includes noncomparative studies (mainly phase II studies), leading to thorny interpretation of the results. METHODS: A systematic search of all the literature in English regarding PNET was performed, based on a MEDLINE search (Pubmed) carried out from January 1970 to May 2005. RESULTS: Approximately 40 trials, including over 1,000 patients, have been retrieved from our MEDLINE search. SST analogs and interferon therapies do allow control over hormone secretion and subsequent symptoms in the majority of treated subjects, but offer a poor tumor growth control rate. Chemotherapies, although more efficient in reducing tumor burden, are often toxic. New approaches such as immunotherapy and targeted therapies are still under investigation. CONCLUSIONS: Whether alone or in combination with surgery, conventional medical therapies represent a crucial aspect of PNET management. Hopefully, in the near future, a new era of antitumoral agents, such as targeted therapies, will strengthen our therapeutic arsenal, either alone or combined with other therapies.

Original languageEnglish (US)
Pages (from-to)475-483
Number of pages9
JournalAmerican Journal of Gastroenterology
Volume103
Issue number2
DOIs
StatePublished - Feb 2008

Fingerprint

Neuroendocrine Tumors
Therapeutics
Somatostatin
MEDLINE
Interferons
Neoplasms
Molecular Targeted Therapy
Drug Therapy
Poisons
Growth
Tumor Burden
PubMed
Immunotherapy
Early Diagnosis
Hormones

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Medical management of pancreatic neuroendocrine tumors. / Delaunoit, Thierry; Neczyporenko, Florence; Rubin, Joseph; Erlichman, Charles; Hobday, Timothy James.

In: American Journal of Gastroenterology, Vol. 103, No. 2, 02.2008, p. 475-483.

Research output: Contribution to journalArticle

Delaunoit, Thierry ; Neczyporenko, Florence ; Rubin, Joseph ; Erlichman, Charles ; Hobday, Timothy James. / Medical management of pancreatic neuroendocrine tumors. In: American Journal of Gastroenterology. 2008 ; Vol. 103, No. 2. pp. 475-483.
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