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Neuroendocrine tumor metastasic treatment

Luis V Syro, Fabio Rotondo, Leon D Ortiz, Kalman Kovacs
Temozolomide is an alkylating chemotherapeutic agent used in malignant neuroendocrine neoplasia, melanoma, brain metastases, and an essential component of adjuvant therapy in the treatment of glioblastoma multiforme and anaplastic astrocytoma. Since 2006 it has been used for the treatment of pituitary carcinomas and aggressive pituitary adenomas. Here, we discuss the current indications and results of temozolomide therapy in pituitary tumors, as well as frequently asked questions regarding temozolomide treatment, duration of therapy, dosage, tumor recurrence, and resistance...
March 13, 2018: Endocrine-related Cancer
Bo Zhou, Canyang Zhan, Yuan Ding, Sheng Yan, Shusen Zheng
Background: Treatment for pancreatic neuroendocrine tumors (PNETs) in patients with unresectable metastatic liver disease has long been a controversial issue. This systematic review aims to summarize the existing evidence concerning the value of primary tumor resection in this group of patients. Methods: A systematic review of the literature and a meta-analysis were performed. The PubMed and Cochrane databases were searched to identify articles that compared palliative primary tumor resection and nonsurgical regimens in patients with PNETs and unresectable liver metastases...
2018: OncoTargets and Therapy
Zhongzhi Jia, Weiping Wang
OBJECTIVE: To evaluate the value of yttrium-90 (90 Y) microspheres in the management of unresectable liver metastases secondary to neuroendocrine tumors (NETs). MATERIALS AND METHODS: PubMed, EMBASE, the Cochrane Database of Systematic Reviews, and the "gray" literature (Google Scholar) were searched for all studies related to90 Y therapy for unresectable liver metastases of NETs. RESULTS: A total of 11 studies and 7 abstracts involving 870 patients were included in the final analysis...
March 2018: European Journal of Radiology
Demetrios Moris, Ioannis Ntanasis-Stathopoulos, Diamantis I Tsilimigras, Stylianos Vagios, Andreas Karamitros, Georgios Karaolanis, John Griniatsos, Alexandros Papalampros, Ioannis Papaconstantinou, Georgios K Glantzounis, Eleftherios Spartalis, Dan G Blazer, Evangelos Felekouras
The widespread use of endoscopy and imaging in combination with the continuous update of the staging systems for neuroendocrine tumors has led to an increase in the incidence of small intestinal neuroendocrine tumors (si-NENs) globally. Despite high survival rates, severe complications may occur even in early stages due to the anatomic location of the primary site and the desmoplastic reaction. Surgery plays a central role in the management of patients with si-NENs. Excision of locoregional disease along with extensive lymph node dissection should be performed in fit patients, even in the presence of metastases...
March 2018: Anticancer Research
Rita Linhas, David Tente, Nuno China, Sara Conde, Ana Barroso
RATIONALE: Carcinoid tumors are derived from neuroendocrine cells and are most frequently found in the gastrointestinal tract and bronchopulmonary system. They are generally characterized by an indolent clinical course but may in some instances spread to regional lymph nodes or to distant sites. Subcutaneous metastases of carcinoid tumors are extremely rare; there are only few cases reported in the literature and the site of the primary tumor was mainly the gastrointestinal tract. Also, the diagnosis of this type of lesions many years after the surgical resection of the pulmonary carcinoid (PC) could be a challenge for clinicians...
January 2018: Medicine (Baltimore)
Katherine D Gray, Maureen D Moore, Suraj Panjwani, Adham Elmously, Cheguevara Afaneh, Thomas J Fahey, Rasa Zarnegar
BACKGROUND: Neuroendocrine tumors (NETs) of the esophagus and stomach are rare neoplasms with variable behavior. We aim to describe their epidemiology and response to treatment. METHODS: NETs of the stomach and the esophagus were selected from the National Cancer Database (2004-2013) and classified by location. Survival analyses were performed with respect to tumor characteristics and treatment variables. RESULTS: NETs of the stomach (n = 2700; 92...
February 23, 2018: Annals of Surgical Oncology
Xu Han, Xuefeng Xu, Hongyun Ma, Yuan Ji, Dansong Wang, Tiantao Kuang, Wenchuan Wu, Bin Song, Gang Li, Gang Jin, Wenhui Lou
PURPOSE: Emerging evidence suggests G3 pancreatic neuroendocrine neoplasms (pNENs) present heterogeneous morphology and biology. The 2017 WHO classification has introduced a new category of well-differentiated pancreatic neuroendocrine tumors (WD-pNETs) G3, compared with poorly differentiated pancreatic neuroendocrine carcinomas (PD-pNECs) G3. We aim to analysis the demographics and outcomes of patients with resectable 2017 WHO G3 pNENs to facilitate the distinction between two entities...
February 2018: Endocrine Connections
Hyun S Kim, Walid L Shaib, Chao Zhang, Ganji Purnachandra Nagaraju, Christina Wu, Olatunji B Alese, Zhengjia Chen, Edith Brutcher, Meredith Renfroe, Bassel F El-Rayes
BACKGROUND: Neuroendocrine tumors (NETs) metastasize to the liver. Everolimus and selective internal radioembolization (SIRT) are approved treatments. Pasireotide is a somatostatin analogue with an affinity for somatostatin receptors 1, 2, 3, and 5. Everolimus and pasireotide may potentiate SIRT radiosensitization and inhibit rebound angiogenesis. This study evaluated the safety of pasireotide, everolimus, and SIRT. METHODS: This 3 + 3 phase 1 trial evaluated 3 dose levels of everolimus (2...
February 16, 2018: Cancer
Maridi Aerts, Hendrik Reynaert
Gastrinomas are functionally active pancreatic neuroendocrine tumors (NETs) secreting gastrin and are associated with local or regional metastases in 60% of the cases. Somatostatin analogs (SSAs) are currently recommended as a first-line treatment for the symptomatic treatment of NETs. Although antiproliferative activity of SSAs has been demonstrated in various cancer types in several in vivo and in vitro studies, clinical benefits with SSAs have been only achieved in a small proportion of patients. We report a disease control on a long-acting SSA lanreotide in a patient with metastatic gastrinoma...
September 2017: Case Reports in Gastroenterology
Mustafa Barbour, Kenneth E Bujold, Brian Joel Tjarks, Ali D Jassim
Small cell lung carcinoma (SCLC), also known as high-grade neuroendocrine tumor of the lung, is exceedingly rare in the pediatric population. SCLC is usually fast growing and often has metastasized at diagnosis. It frequently responds well to therapy initially, however, has a high relapse and mortality rate. There are limited published data on SCLC in children and no existing pediatric treatment protocols. In this report, we present a case of extensive stage SCLC in a 15-year-old boy who responded to single-agent gemcitabine therapy and review similar cases reported in the medical literature...
February 2, 2018: Journal of Pediatric Hematology/oncology
Ruth Brown, Phei Shan Chuah, Emmanouil Panagiotidis, Sobhan Vinjamuri
A 54-year-old female treated for locally advanced ductal breast carcinoma was also diagnosed with a pancreatic neuroendocrine tumour. A staging 68Ga DOTANOC positron emission tomography/computed tomography (PET/CT) demonstrated somatostatin receptor-positive foci within the brain parenchyma. A whole body 18F-fluoride PET/CT also demonstrated several foci of low-grade tracer uptake in the brain. Magnetic resonance imaging confirmed several cerebral and cerebellar metastases. This case highlights the need to be aware of each tumor's metastatic profile and the careful attention required for thoroughly evaluating imaging in the presence of multiple pathologies...
January 2018: World Journal of Nuclear Medicine
S Deguelte, L de Mestier, O Hentic, J Cros, R Lebtahi, P Hammel, R Kianmanesh
The management of patients with pancreatic neuroendocrine tumor (PNET), whether hormonally secretory or not, is multidisciplinary and often multimodal. Surgical treatment plays a central role because complete resection is the only potentially curative treatment. The choice of the therapeutic plan for a PNET requires precise localization of the primary tumor (which may sometimes be multiple in case of genetic predisposition), confirmation of the diagnosis of PNET, a search for metastases (mainly hepatic), and identification of the main histoprognostic factors...
January 31, 2018: Journal of Visceral Surgery
Shusuke Akamatsu, Takahiro Inoue, Osamu Ogawa, Martin E Gleave
Treatment-related neuroendocrine prostate cancer is a lethal form of prostate cancer that emerges in the later stages of castration-resistant prostate cancer treatment. Treatment-related neuroendocrine prostate cancer transdifferentiates from adenocarcinoma as an adaptive response to androgen receptor pathway inhibition. The incidence of treatment-related neuroendocrine prostate cancer has been rising due to the increasing use of potent androgen receptor pathway inhibitors. Typically, treatment-related neuroendocrine prostate cancer is characterized by either low or absent androgen receptor expression, small cell carcinoma morphology and expression of neuroendocrine markers...
February 3, 2018: International Journal of Urology: Official Journal of the Japanese Urological Association
Trevan Fischer, Shrawan Gaitonde, Maris Jones, Bradley Bandera, Melanie Goldfarb
Paragangliomas (PGL) are rare neuroendocrine tumors. This study describes the largest collection of PGLs and evaluates factors that impact survival. Patients with PGL from 1998 to 2013 in the NCDB were reviewed. Independent predictors of overall survival (OS) were identified for patients with non-central nervous system (CNS) tumors. Of 867 PGLs, the primary site was CNS (39.9%), abdomen/pelvis (A&P) (21.0%), head and neck (H&N) (17.5%), thoracic (15.1%), bladder (3%), or unspecified (3.5%). Of 521 non-central nervous system (CNS) PGLs, there were differences in sex, comorbidities, treatment facility, tumor size, treatment modality (P < 0...
October 1, 2017: American Surgeon
Gang Xu, Peipei Wang, Yao Xiao, Xin Wu, Guole Lin
RATIONALE: Rectal neuroendocrine tumor (NET) is a relatively rare tumor. Well-differentiated NETs (G1 and G2) rarely display distant metastasis at initial diagnosis. Currently, treatment for the primary lesions of rectal NETs with liver metastasis remains controversial. The liver metastasis was resected in local hospital. Transanal endoscopic microsurgery (TEM) has emerged as an effective minimally invasive surgery for local resection of lower rectal lesions. Herein, we reported the initial application of TEM to remove the rectal primary lesion in patients with low rectal NETs (G2) with giant liver metastases...
December 2017: Medicine (Baltimore)
S Grozinsky-Glasberg, G Kaltsas, M Kaltsatou, N Lev-Cohain, A Klimov, V Vergadis, I Uri, A I Bloom, D J Gross
BACKGROUND: Liver metastases are common in patients with neuroendocrine tumors (NETs), having a negative impact on disease prognosis. The options for selective therapy in patients with unresectable multiple liver metastases are limited to TACE (transarterial chemoembolization), TAE (transarterial embolization), or SIRT (selective internal radiation therapy). AIM: To explore the clinical outcome, survival and safety of these therapies in NETs patients. METHODS: Retrospective case series of consecutive patients (mean age 56...
January 30, 2018: Endocrine
Pablo Chicharro, Amalia Paniagua, Pedro Rodríguez-Jiménez, Sara Ibañes, Begoña Cortina, Javier Ribeiro, Miguel Ángel Sampedro-Núñez, Javier Fraga, Mónica Marazuela, Esteban Daudén
BACKGROUND: The presence of cutaneous nodules in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) receiving depot somatostatin analogs (SSAs) is a diagnostic challenge as differential diagnosis between injection site reactions and metastases is essential. OBJECTIVE: To characterize the clinical, radiological, cytological and histopathological features of subcutaneous nodules in patients with GEP-NETs treated with SSAs. MATERIALS AND METHODS: Retrospective, cross-sectional study of patients with GEP-NETs treated with SSAs in whom subcutaneous nodules were detected on routine abdominal CT scans...
January 29, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Carlo Sposito, Michele Droz Dit Busset, Davide Citterio, Marco Bongini, Vincenzo Mazzaferro
Liver metastases occur in nearly half of NET patients (MNETs) and heavily affect prognosis, with 5-yr. OS around 19-38%. Although it is difficult to show outcome differences for available treatments, due to the long course of disease, surgery for MNETs remains the most effective option in terms of survival and symptom control. Since MNETs frequently present as an oligo-metastatic, liver-limited disease, unresectable in 80% of cases, liver transplantation (LT) has emerged as a potential curative treatment. Nevertheless, experience with LT for MNETs is limited and burdened by highly heterogeneous outcomes and significant recurrence rate, mostly explained by the variability of selection criteria...
January 23, 2018: Reviews in Endocrine & Metabolic Disorders
Peng Liu, Xu Zhu, Jie Li, Ming Lu, Jiahua Leng, Ying Li, Jiangyuan Yu
Objective: To analyze the angiography appearance of liver metastases from gastroenteropancreatic neuroendocrine tumors (GEP-NETs), and evaluate the clinical efficacy and prognostic factors of interventional treatment for hepatic metastases. Methods: Fifty GEP-NETs patients with hepatic metastases were treated from January 2012 to December 2016, and received transarterial embolization (TAE) in the hepatic tumor or hepatic arterial infusion chemotherapy (HAIC). All patients received 179 times of the intervention therapy in total...
December 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Michiko Kaiho-Sakuma, Masafumi Toyoshima, Mika Watanabe, Asami Toki, Satomi Kameda, Takamichi Minato, Hitoshi Niikura, Nobuo Yaegashi
•Neuroendocrine tumors (NETs) frequently occur in the lungs or the gastrointestinal tract; they are uncommon in the ovary.•The mammalian target of rapamycin (mTOR) pathway has been reported as a treatment for advanced NETs.•We describe a patient with an aggressive primary ovarian NET, successfully treated with everolimus (an mTOR inhibitor).
February 2018: Gynecologic Oncology Reports
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