Review

Targeted Oncology

, Volume 7, Issue 3, pp 169-172

First online:

New treatment options with cytotoxic agents in neuroendocrine tumours

  • Pascal HammelAffiliated withService de Gastroenterologie-Pancreatologie, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII) Email author 
  • , Olivia HenticAffiliated withService de Gastroenterologie-Pancreatologie, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII)
  • , Cindy NeuzilletAffiliated withService de Gastroenterologie-Pancreatologie, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII)
  • , Sandrine FaivreAffiliated withOncology Unit, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII)
  • , Eric RaymondAffiliated withOncology Unit, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII)
  • , Philippe RuszniewskiAffiliated withService de Gastroenterologie-Pancreatologie, Hôpital Beaujon, AP-HP, Faculté Denis Diderot (Paris VII)

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Abstract

There are numerous treatment options for patients with advanced digestive neuroendocrine tumours (NETs). Medical treatment includes systemic chemotherapies, targeted therapies, somatostatin analogs, liver-directed therapies such as (chemo)embolization or thermoablation, and peptide receptor radionuclide therapy. Cytotoxic chemotherapies can help control tumour progression in patients with non-resectable tumours and may improve symptoms by reducing tumour bulk. In addition, tumour response is usually greater than that obtained with targeted therapies. This should be taken into consideration in neoadjuvant strategies. Efficacy of temozolomide depends on the O6 methylguanine DNA methyl transferase status, and thus, this drug will likely have to be considered in the future in patients with a favourable enzyme profile. Because numerous treatment options are available for patients with advanced digestive NETs, and thanks to their long survival, successive drugs should be used. Careful attention should be paid to the adverse events in order to maintain the quality of life in these patients who have with a long life expectancy.

Keywords

Neuroendocrine Tumour Digestive Pancreas Carcinoid Chemotherapy Streptozotocin Temozolomide MGMT