Journal of Gastrointestinal Cancer

, Volume 43, Issue 4, pp 532–540

Clinical Pathways for Pancreatic Neuroendocrine Tumors

  • Angela Alistar
  • Max Sung
  • Michelle Kim
  • Randall F. Holcombe
Review Article

DOI: 10.1007/s12029-012-9397-y

Cite this article as:
Alistar, A., Sung, M., Kim, M. et al. J Gastrointest Canc (2012) 43: 532. doi:10.1007/s12029-012-9397-y

Abstract

Background

Pancreatic neuroendocrine tumors (PNETs) represent a group of diseases that pose diagnostic and therapeutic challenges due to their clinical and pathological heterogeneity as well as the limited number of patients available for clinical trials. Over the last couple of decades, a major progress in understanding tumor biology led to the discovery of new potential targets for the medical treatment of these tumors.

Discussion

There are numerous novel targeted agents in various stages of preclinical and clinical development that offer considerable promise as monotherapy or combination therapy for PNETs. The question of whether traditional clinical research methods are appropriate for the development of novel, targeted anticancer agents has been the subject of many discussions. Major challenges include identifying a valid target, the most effective agent within a target class, the right subset of population to benefit from the drug, and the most appropriate setting to use the drug. As new agents emerge, oncologists are faced with making clinical decisions sometimes before having a high level of evidence. In this review, we attempt to address some of the management steps involved in treating patients with pancreatic neuroendocrine tumors, particularly well to moderately differentiated tumors. The purpose of this review is to offer a therapeutic sequence including surgery, liver-directed therapy, chemotherapy, and targeted therapy for this disease.

Keywords

Pancreatic neuroendocrine tumors Targeted therapy Clinical management 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Angela Alistar
    • 1
  • Max Sung
    • 1
  • Michelle Kim
    • 2
  • Randall F. Holcombe
    • 1
  1. 1.Division of Hematology/Oncology, Tisch Cancer InstituteMount Sinai School of MedicineNew YorkUSA
  2. 2.Division of GastroenterologyMount Sinai School of MedicineNew YorkUSA

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