Prognostic and predictive role of the PI3K–AKT–mTOR pathway in neuroendocrine neoplasms
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Neuroendocrine neoplasms (NENs) are considered a heterogeneous and rare entity. Its natural history is influenced by multiple clinicopathological characteristics, which guide the management of these patients. The development of molecular biology reveals that the PI3K–AKT–mTOR pathway plays a relevant role in tumorigenesis and progression of NENs. Mammalian target of rapamycin (mTOR) inhibitors, targeted agents that block this pathway, has improved outcomes in neuroendocrine tumors (NETs). Different therapeutic approaches, such as somatostatin analogs, chemotherapy, peptide receptor radionuclide therapy, and targeted agents, have shown benefits in the treatment of NETs. However, there are not any established prognostic or predictive biomarkers to select the best therapy option to individualize treatment. Although a relation between alterations in the PI3K–AKT–mTOR pathway and clinical outcomes has not been found, these anomalies are considered attractive biomarkers. Additional molecular analysis should be integrated in future clinical trials’ design to identify potential predictive or prognostic biomarkers.
KeywordsNeuroendocrine neoplasm Neuroendocrine tumors PI3K–AKT–mTOR pathway Predictive Prognostic mTOR Inhibitors
Compliance with ethical standards
The manuscript does not contain clinical studies or patient data.
Conflict of interest
EG. has served as advisor and delivered lectures for Novartis, Pfizer, and IPSEN. P.G. T.A-G, and O.M-S declare no conflict of interest related to this publication.
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