Personalized treatment approach to gastroenteropancreatic neuroendocrine tumors: a medical oncologist's perspective. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Paul, Davinder; Ostwal, Vikas; Bose, Subhadeep; Basu, Sandip; Gupta, Sudeep
• Is Part Of: European journal of gastroenterology & hepatology. Volume 28:Issue 9(2016:Sep.)
• Publication Date: 2016-09
• Subjects: chemotherapy -- differentiation -- gastrointestinal neuroendocrine tumors -- histopathological grades -- somatostatin receptor receptors; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000000674
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : The medical management of gastroenteropancreatic neuroendocrine tumors involves treatment of symptomatic disease related to hormone secretions or bulky unresectable metastatic disease. Combining gallium DOTA with fluorine-18 fluorodeoxyglucose-PET along with histopathological grading helps to determine tumor heterogeneity and seek reasons for poor response to therapy. In the light of adding chemotherapy in selected patients with intermediate-grade tumors, the newer scan helps in personalization of the therapy along with the biopsy. The tumor dedifferentiation over the particular time period leading to aggressive behavior, a well-known entity, is contrasted with the redifferentiation phenomenon in some patients as a result of chemotherapy or targeted drug therapy. This may support the basis for combining peptide receptor-targeted radiotherapy/octreotide therapy with chemotherapy or mTOR inhibitors such as everolimus.