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Management of Neuroendocrine Tumors of the Pancreas and Digestive Tract pp 65–75Cite as

Streptozocin-Based Chemotherapy: Still a Standard of Care for Neuroendocrine Tumours?

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Abstract

Streptozocin (STZ)-based chemotherapy has been used for over 40 years in the treatment for neuroendocrine tumours (NETs); however, there have been few randomized trials, and STZ remains unlicensed in many countries. With the recent approval of sunitinib and everolimus for pancreatic NETs (PNETs), and the emergence of a more stratified approach to cancer therapy, it is timely to re-evaluate the role of STZ for NETs. Here, we review the evidence base for STZ-based chemotherapy, the toxicity associated with treatment and the position of STZ in the current therapeutic algorithm. Although there are no trials comparing chemotherapy with best supportive care, there is evidence that multi-agent STZ-containing regimens are associated with improved survival compared with control therapy. Additionally, in PNETs, chemotherapy appears to be associated with higher response rates compared with targeted therapies and this may be important in those who are symptomatic from tumour burden and those with locally advanced disease who may be down-staged for resection. The role of Ki67 and other predictive markers requires further assessment in prospective studies as does the relative efficacy of alternative agents such as temozolomide (TMZ).

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Authors and Affiliations

  1. Department of Oncology, Royal Free Hospital, London, NW3 2QG, UK

    Saira Khalique & Tim Meyer

  2. UCL Cancer Institute, University College London, 72 Huntley Street, London, WC1E 6DD, UK

    Tim Meyer

Authors
  1. Saira Khalique
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  2. Tim Meyer
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Correspondence to Tim Meyer .

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Editors and Affiliations

  1. Medical Oncology, Bichat-Beaujon University Hospitals, Clichy cedex, France

    Eric Raymond

  2. Bichat-Beaujon University Hospitals Medical Oncology, Clichy cedex, France

    Sandrine Faivre

  3. Pancreatology, Bichat-Beaujon University Hospitals Gastroenterology and, Clichy cedex, France

    Philippe Ruszniewski

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Khalique, S., Meyer, T. (2014). Streptozocin-Based Chemotherapy: Still a Standard of Care for Neuroendocrine Tumours?. In: Raymond, E., Faivre, S., Ruszniewski, P. (eds) Management of Neuroendocrine Tumors of the Pancreas and Digestive Tract. Springer, Paris. https://doi.org/10.1007/978-2-8178-0430-9_5

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  • DOI: https://doi.org/10.1007/978-2-8178-0430-9_5

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  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0429-3

  • Online ISBN: 978-2-8178-0430-9

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