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Neuroendocrine Tumors in Real Life pp 325–333Cite as

Therapy for Metastatic Disease: Bronchi

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Abstract

The clinical management for advanced metastatic lung-NETs requires a multidisciplinary approach involving surgeons, medical and radiation oncologist, as well as endocrinologist. The main aims of the management of lung-NETs are to control the tumor growths as well as endocrine secretory activity. Surgical removal is the treatment of choice for lung-NETs with the aim to remove as much tumor tissue as possible, preserving the lung tissue. Pulmonary surgery is considered in patients with typical and atypical lung-NETs with low proliferation and slow growths, with the aim to remove as much as 90% of metastatic disease. For symptomatic control somatostatin analogs are still the major treatment modality but can sometimes be complimented by interferon and PRRT. To control tumor growth, somatostatin analogs are still a valid alternative for low-proliferating, well-differentiated lung-NETs, supplemented sometimes by local regional therapies such as radiofrequency ablation, embolization, and radioembolization. Systemic cytotoxic treatments include temozolomide alone or in combination with capecitabine. Significant antitumor activity has not been seen in low-grade lung-NETs. Carboplatin plus etoposide is applied in high-grade tumors. Everolimus has now demonstrated in at least two big trials and significant antitumor activity for lung-NETs and is registered for the treatment of low- and intermediate-grade lung-NETs. PRRT is an important adjunct to the treatment arsenal, but there are still limited results published. Combinations of several treatment modalities concomitantly or sequentially are most often applied.

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Author information

Authors and Affiliations

  1. Endocrine Oncology, Uppsala University Hospital, Uppsala, Sweden

    Kjell Öberg MD, PhD

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  1. Kjell Öberg MD, PhD
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Correspondence to Kjell Öberg MD, PhD .

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Editors and Affiliations

  1. ENETs Center of Excellence for Neuroendocrine Tumours, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy

    Annamaria Colao

  2. ENETs Center of Excellence for Neuroendocrine Tumours, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy

    Antongiulio Faggiano

  3. Endocrine Oncology, Internal Medicine Department, Erasmus University, Rotterdam, Zuid-Holland, The Netherlands

    Wouter de Herder

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Öberg, K. (2018). Therapy for Metastatic Disease: Bronchi. In: Colao, A., Faggiano, A., de Herder, W. (eds) Neuroendocrine Tumors in Real Life. Springer, Cham. https://doi.org/10.1007/978-3-319-59024-0_23

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  • DOI: https://doi.org/10.1007/978-3-319-59024-0_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59022-6

  • Online ISBN: 978-3-319-59024-0

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