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Advances in the treatment of GEP neuroendocrine tumors in Japan
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T. Ito1,
K. Kawabe2,
L. Lee3 |
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1Neuroendocrine Tumor Center, Fukuoka Sanno Hospital, International University of Health and Welfare, 2Department of Medicine & Bioregulatory Science, Kyushu University, 3Digestive Diseases Branch, National Institutes of Health |
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| Several new developments have occurred in the treatment of gastroentero-pancreatic neuroendocrine tumors (GEP-NETs) in Japan. The therapeutic approach to GEP-NETs associated with remote metastasis is changing. Even in cases with liver metastases, surgical treatment is the standard therapy if curative resection is possible. However, because recently developed molecular-targeted agents, such as everolimus and sunitinib, and chemotherapy of streptozotocin have now become covered under insurance in Japan. On the other hand, somatostatin analogs have been developed.Initially to palliate hormonal symptoms.Recently, their anti-proliferative effects have been reported.The results of PROMID and CLARINET studies demonstrated the antitumor effects for midgut NET. CLARINET demonstrated a beneficial effect in patients with pNET as well.Last year, RADIANT-4 demonstrated a statistically significant and clinically meaningful prolongation of PFS in patients with non-functional NET of lung or GI origin. Everolimus is the first targeted agent to show robust anti-tumour activityacross a broad spectrum of NETs, including those arising from the pancreas, lung and GI tract.Finally, regarding the treatment strategy for GEP-NETs, the management of liver metastasis is important. Multimodality therapy that accounts for the tumor stage, degree of tumor differentiation, tumor volume, and speed of tumor growth is required. |
Index Term 1: neuroendocrine tumors
Index Term 2: molecular targeted therapy |
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