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Progress in the Treatment of Small Intestine Cancer

  • Lower Gastrointestinal Cancers (AB Benson, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Small intestine cancer is rare, accounting for approximately 3% of all gastrointestinal malignancies. The most common histological subtypes include adenocarcinoma, neuroendocrine tumours (NETs) and gastrointestinal stromal tumours (GISTs). In localised disease, surgery remains the mainstay of treatment and the best approach to improve survival. Current treatment for small intestine adenocarcinoma (SIA) is extrapolated from small studies and data from colorectal cancer (CRC). There is limited evidence to guide therapy in the adjuvant setting. However, there are small phase II studies in the advanced setting providing evidence for the role of chemotherapy and immunotherapy. There is also limited evidence assessing the efficacy of targeted therapies. Small intestine NETs are rare, with evidence for somatostatin analogue therapy, particularly in the low to intermediate-grade well-differentiated tumours. Poorly differentiated NETs are generally managed with chemotherapy but have worse outcomes compared with well-differentiated NETs. The management of small intestine GISTs is largely targeting KIT mutations with imatinib. Recent trials have provided evidence for effective therapies in imatinib-resistant tumours and the potential role of immunotherapy. The aim of this article was to review the evidence for the current management and recent advances in the management of small intestine adenocarcinoma, NETs and GISTs.

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  1. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, High St, Randwick, Sydney, NSW, 2031, Australia

    Rebecca Symons BMed, MD, Daniel Daly BSc, MBBS, MS, FRACS, Robert Gandy MB, ChB, MRCS, MS, FRACS, David Goldstein MBBS, FRACP & Morteza Aghmesheh MD, FRACP, PhD, GradDipSc

  2. University of New South Wales, Randwick, NSW, Australia

    Daniel Daly BSc, MBBS, MS, FRACS, Robert Gandy MB, ChB, MRCS, MS, FRACS & David Goldstein MBBS, FRACP

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  1. Rebecca Symons BMed, MD
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Correspondence to Morteza Aghmesheh MD, FRACP, PhD, GradDipSc.

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Rebecca Symons declares that she has no conflict of interest. Daniel Daly declares that he has no conflict of interest. Robert Gandy declares that he has no conflict of interest. David Goldstein declares grants from Bayer, BMS, personal fees from Panbela and personal fees from Boehringer Ingelheim all outside the submitted work. Morteza Aghmesheh declares that he has no conflict of interest.

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Symons, R., Daly, D., Gandy, R. et al. Progress in the Treatment of Small Intestine Cancer. Curr. Treat. Options in Oncol. 24, 241–261 (2023). https://doi.org/10.1007/s11864-023-01058-3

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