Biology and Systemic Treatment of Advanced Gastroenteropancreatic Neuroendocrine Tumors

2018 ◽  
pp. 292-299 ◽  
Author(s):  
Nitya Raj ◽  
Nicola Fazio ◽  
Jonathan Strosberg
Keyword(s):  
Neuroendocrine Tumors ◽  
Systemic Treatment ◽  
Future Research ◽  
Neuroendocrine Neoplasms ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Treatment Approaches ◽  
Biologic Characterization ◽  
Scientific Advances

In recent years, there have been important scientific advances in the biologic characterization of neuroendocrine neoplasms and in their treatment. This review will describe these scientific advances, the evolving systemic treatment approaches, and important topics to be addressed in future research.

scholarly journals Emerging Treatment Options for Gastroenteropancreatic Neuroendocrine Tumors

2020 ◽  
Vol 9 (11) ◽  
pp. 3655
Author(s):  
Mauro Cives ◽  
Eleonora Pelle’ ◽  
Jonathan Strosberg
Keyword(s):  
Clinical Trials ◽  
Growth Factor ◽  
Neuroendocrine Tumors ◽  
Treatment Options ◽  
Somatostatin Receptor ◽  
Growth Factor Receptor ◽  
Small Samples ◽  
Neuroendocrine Neoplasms ◽  
Two Phase ◽  
Gastroenteropancreatic Neuroendocrine Tumors

Treatment options for neuroendocrine tumors (NETs) and carcinomas (NECs) are expanding. Early-phase studies have shown preliminary evidence of the antitumor activity of alpha-emitting peptide receptor radionuclide therapy (PRRT), and novel radiopeptides incorporating somatostatin receptor antagonists (rather than agonists) have been developed. Several tyrosine kinase inhibitors (TKIs) with antiangiogenic potential have been evaluated in patients with NETs, including lenvatinib, axitinib, cabozantinib and pazopanib. Recently, two phase 3 clinical trials have demonstrated the efficacy and safety of surufatinib, an inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, -3, fibroblast growth factor receptor (FGFR)-1 and colony stimulating factor-1 receptor (CSF-1R), in patients with pancreatic and extra-pancreatic NETs. Multiple clinical trials of combination immunotherapy have been recently completed, but interpretation of the results is hampered by small samples sizes and discordant outcomes. This review summarizes recent data on emerging treatments for neuroendocrine neoplasms.

scholarly journals Local treatment for focal progression in metastatic neuroendocrine tumors

2019 ◽  
Vol 26 (4) ◽  
pp. 405-409 ◽  
Author(s):  
Taymeyah Al-Toubah ◽  
Stefano Partelli ◽  
Mauro Cives ◽  
Valentina Andreasi ◽  
Franco Silvestris ◽  
...  
Keyword(s):  
Median Time ◽  
Neuroendocrine Tumors ◽  
Systemic Treatment ◽  
Local Treatment ◽  
Arterial Embolization ◽  
External Beam Radiation ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Beam Radiation ◽  
Additional Intervention ◽  
Systemic Treatments

New systemic treatments have improved the therapeutic landscape for patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs). While drugs such as everolimus, sunitinib, temozolomide and 177Lutetium-dotatate are appropriate for patients with widespread disease progression, local treatment approaches may be more appropriate for patients with unifocal progression. Surgical resection, radiofrequency ablation (RFA), hepatic arterial embolization (HAE) or radiation, can control discrete sites of progression, allowing patients to continue their existing therapy and sparing them toxicities of a new systemic treatment. We identified 69 patients with metastatic GEP-NETs who underwent a local treatment for focal progression in the setting of widespread metastases. Twenty-six percent underwent resection, 27% RFA, 23% external beam radiation and 23% selective HAE. With a median follow-up of 25 months, 42 (61%) patients subsequently progressed to the point of requiring additional intervention (12 locoregional, 30 systemic) for disease control. Median time to new systemic treatment was 32 months (95% CI, 16.5–47.5 months). Median time to any additional intervention was 19 months (95% CI, 8.7–25.3 months). Control of local sites of progression enabled the majority of patients to remain on their existing systemic treatment and avoid potential toxicities associated with salvage systemic therapy.

Parasite defense mechanisms in bees: behavior, immunity, antimicrobials, and symbionts

2019 ◽  
Vol 4 (1) ◽  
pp. 59-76 ◽  
Author(s):  
Alison E. Fowler ◽  
Rebecca E. Irwin ◽  
Lynn S. Adler
Keyword(s):  
Defense Mechanisms ◽  
Poor Quality ◽  
Future Research ◽  
Immune Priming ◽  
Social Bees ◽  
Bee Health ◽  
Landscape Scales ◽  
And Function ◽  
Solitary Species

Parasites are linked to the decline of some bee populations; thus, understanding defense mechanisms has important implications for bee health. Recent advances have improved our understanding of factors mediating bee health ranging from molecular to landscape scales, but often as disparate literatures. Here, we bring together these fields and summarize our current understanding of bee defense mechanisms including immunity, immunization, and transgenerational immune priming in social and solitary species. Additionally, the characterization of microbial diversity and function in some bee taxa has shed light on the importance of microbes for bee health, but we lack information that links microbial communities to parasite infection in most bee species. Studies are beginning to identify how bee defense mechanisms are affected by stressors such as poor-quality diets and pesticides, but further research on this topic is needed. We discuss how integrating research on host traits, microbial partners, and nutrition, as well as improving our knowledge base on wild and semi-social bees, will help inform future research, conservation efforts, and management.

Gastroenteropancreatic neuroendocrine tumors: descriptive study in a reference Spanish hospital

2013 ◽  
Author(s):  
Zayas Beatriz Leon de ◽  
Olmo Garcia Maria Isabel del ◽  
Agustin Ramos Prol ◽  
Antonia Perez Lazaro ◽  
Susana Tenes Rodrigo ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Descriptive Study ◽  
Gastroenteropancreatic Neuroendocrine Tumors ◽  
Spanish Hospital

Evaluation of neurofibromatosis type 1 and gastroenteropancreatic neuroendocrine tumors.

2018 ◽  
Author(s):  
Juan Carlos Percovich ◽  
Jose Atencia ◽  
Rogelio Garcia ◽  
Marcel Sambo ◽  
Montserrat Blanco ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Neurofibromatosis Type 1 ◽  
Neurofibromatosis Type ◽  
Gastroenteropancreatic Neuroendocrine Tumors

NEUROENDOCRINE TUMORS OF THE PANCREAS: ETIOLOGY, PATHOGENESIS, DIAGNOSIS, AND CURRENT TREATMENT APPROACHES

2018 ◽  
Vol 64 (6) ◽  
pp. 830-839
Author(s):  
Temuri Morgoshiya
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Manifestations ◽  
Gastrointestinal Hormones ◽  
Current Treatment ◽  
High Potential ◽  
Long Term Results ◽  
Considerable Part ◽  
Treatment Approaches ◽  
By Products

The overview of literature on modem classification issues, diagnostics and treatments of neuroendocrinal tumors of a pancreas is provided. According to modern views all neuroendocrinal tumors of a pancreas having clinical manifestations (in the form of the syndromes caused by products of specific hormones; increases in level of hormones in blood of patients without clinical manifestations; in the form of signs of existence of volume education in various departments of PZh) and/or the researches (more than 5 mm) revealed by means of beam methods are malignant in the biology as they have high potential to innidiation. In article it is shown that a considerable part of neuroendocrinal tumors of a pancreas are nonfunctioning, i.e. not cosecreting various gastrointestinal hormones and polypeptides in blood and thereof not followed characteristic clinical manifestations. It is noted that diagnostics of neuroendocrinal tumors of a pancreas is extremely difficult task on which solution the choice of a method of treatment and its long-term results depends...

Advances in the Systemic Treatment of Neuroendocrine Tumors in the Era of Molecular Therapy

2013 ◽  
Vol 13 (3) ◽  
pp. 382-388 ◽  
Author(s):  
Roland Leung ◽  
Brian Lang ◽  
Hilda Wong ◽  
Joanne Chiu ◽  
Wan K. Yat ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Systemic Treatment ◽  
Molecular Therapy
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