Onkológia 5/2021

Systemic treatment of neuroendocrine tumours

Neuroendocrine neoplasms (NEN) are heterogeneous tumours in terms of primary origin, molecular features and clinical presentation. The stage of the disease in accordance with the TNM classification and the level of tumour differentiation are the two main independent prognostic parameters that are crucial for further management of the patient. NEN are also characterized by expression of somatostatin receptors, a target that has been extremely important for diagnosis and treatment (somatostatin analogues (SSA) and peptide-receptor radionuclide therapy (PRRT)). In case a progressive phase of the disease is detected interferone alpha as well as targeted mTOR therapy, tyrosine kinase inhibitors and chemotherapy can be applied. Chemotherapy is of limited use for NEN of non-pancreatic origin, and the only approved targeted agents for advanced progressive NEN are sunitinib for those of pancreatic origin, and everolimus for lung, gastrointestinal and pancreatic primaries. Immunotherapy with regard to NEN is still subject to clinical research.

Keywords: neuroendocrine tumours, somatostatin analogues, targeted therapy, chemotherapy, imunotherapy