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Neuroendocrine Tumours: Diagnosis, Therapy and Follow-up

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Book cover Atlas of Thyroid and Neuroendocrine Tumor Markers

Abstract

Neuroendocrine neoplasms (NENs) represent a clinically and pathologically heterogeneous group of tumours showing peculiar phenotypic characteristics and a common origin from cells of the diffuse neuroendocrine system [1–4]. NENs are commonly considered to be rare if compared to corresponding non-neuroendocrine neoplasms. Their frequency, however, has increased considerably in recent decades, as reported by epidemiological studies, such as the Surveillance, Epidemiology and End Results (SEER) registers in the USA, showing an increase of 1–5 new cases per 100,000/year [5]. In view of the more favourable prognosis of gastroenteropancreatic (GEP)-NEN than non-neuroendocrine neoplasms, the prevalence of GEP-NEN is 35 cases/100,000, shortly after colon adenocarcinoma and before all other gastroenteric adenocarcinomas [1].

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References

  1. Pearse AG. The diffuse neuroendocrine system: peptides, amines, placodes and the APUD theory. Prog Brain Res. 1986;68:25–31.

    Article  CAS  PubMed  Google Scholar 

  2. Rosai J. An evolutionary view of neuroendocrine cells and their tumors. Int J Surg Pathol. 2001;9:87–92.

    Article  CAS  PubMed  Google Scholar 

  3. Solcia E, Klöppel G, Sobin LH, editors. World Health Organization. International Histological Classification of Tumors: Histologic Typing of Endocrine Tumors. Berlin: Springer; 2000.

    Google Scholar 

  4. Travis WD, Brambilla E, Muller-Hermelink HK, Harris CC. Pathology & Genetics: Tumours of the Lung, Pleura, Thymus and Heart, WHO International Histological Classification of Tumours. Lyon: IARC Press; 2004.

    Google Scholar 

  5. Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, Abdalla EK, Fleming JB, Vauthey JN, Rashid A, Evans DB. One hundred years after “carcinoid”: epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008;20(26):3063–72.

    Article  Google Scholar 

  6. Bosman FT, et al. World Health Organization Classification of Tumours. Pathology and Genetics. Tumors of the Digestive System. Lyon: IARC Press; 2010.

    Google Scholar 

  7. Vinik AI, et al. NANETS consensus guidelines for the diagnosis of neuroendocrine tumor. Pancreas. 2010;39:713–34.

    Article  PubMed  Google Scholar 

  8. Panzuto F, Boninsegna L, Fazio N, et al. Metastatic and locally advanced pancreatic endocrine carcinomas: analysis of factors associated with disease progression. J Clin Oncol. 2011;29:2372–7.

    Article  PubMed  Google Scholar 

  9. Panzuto F, Campana D, Fazio N, et al. Risk factors for disease progression in advanced jejunoileal neuroendocrine tumors. Neuroendocrinology. 2012;96:32–40.

    Article  CAS  PubMed  Google Scholar 

  10. Boninsegna L, Panzuto F, Partelli S, et al. Malignant pancreatic neuronendocrine tumour: lymph node ratio and Ki67 are predictors of recurrence after curative rsection. Eur J Cancer. 2012;48:1608–15.

    Article  PubMed  Google Scholar 

  11. Niederle MB, Niederle B. Diagnosis and treatment of gastroenteropancreatic neuroendocrinetumors: current data on a prospectively collected, retrospectively analyzed clinical multicenter investigation. Oncologist. 2011;16:602–13.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ahmed A, Turner G, King B, Jones L, Culliford D, McCance D, Ardill J, Johnston BT, Poston G, Rees M, Buxton-Thomas M, Caplin M, Ramage JK. Midgut neuroendocrine tumours with liver metastases: results of the UKINETS study. Endocr Relat Cancer. 2009;16:885–94.

    Article  CAS  PubMed  Google Scholar 

  13. Helland SK, Prosch AM, Viste A. Carcinoid tumours in the gastrointestinal tract—a population-based study from Western Norway. Scand J Surg. 2006;95:158–61.

    Article  CAS  PubMed  Google Scholar 

  14. Pape UF, Berndt U, Muller-Nordhorn J, Bohmig M, Roll S, Koch M, Willich SN, Wiedenmann B. Prognostic factors of long-term outcome in gastroenteropancreatic neuroendocrine tumours. Endocr Relat Cancer. 2008;15:1083–97.

    Article  PubMed  Google Scholar 

  15. Pape UF, Bohmig M, Berndt U, Tiling N, Wiedenmann B, Plockinger U. Survival and clinical outcome of patients with neuroendocrine tumors of the gastroenteropancreatic tract in a German referral center. Ann N Y Acad Sci. 2004;1014:222–33.

    Article  PubMed  Google Scholar 

  16. Phan AT, Oberg K, Choi J, et al. NANETS consensus guideline for the diagnosis and management of neuroendocrine tumors: well-differentiated neuroendocrine tumors of the thorax (includes lung and thymus). Pancreas. 2010;39:784–98.

    Article  PubMed  Google Scholar 

  17. Oberg K, et al. Neuroendocrine bronchial and thymic tumors: ESMO clinical recommendation for diagnosis, treatment and follow-up. Ann Oncol. 2008;19:ii102–3.

    PubMed  Google Scholar 

  18. Wick ME, et al. Carcinoid tumor of the thymus: a clinicopathologic report of seven cases with review of litterature. Mayo Clin Proc. 1980;55:246–54.

    CAS  PubMed  Google Scholar 

  19. Dusmet ME, et al. Pulmonary and thymic carcinoid tumors. World J Surg. 1996;20:189–95.

    Article  CAS  PubMed  Google Scholar 

  20. Chaer R, et al. Primary neuroendocrine tumors of the thymus. Ann Thorac Surg. 2002;74:1733–40.

    Article  PubMed  Google Scholar 

  21. Ruffini E, et al. Neuroendocrine tumors of the thymus. Thorac Surg Clin. 2011;21:13–23.

    Article  PubMed  Google Scholar 

  22. De Perrot M, et al. Neuroendocirne carcinoma (carcinoid) of the thymus associated with Cushing’s syndrome. Ann Thorac Surg. 2002;73:675–81.

    Article  PubMed  Google Scholar 

  23. Wu MH, et al. Thymic carcinoid combined with myasthenia gravis. J Thorac Cardiovasc Surg. 2004;127:584–5.

    Article  PubMed  Google Scholar 

  24. Liu HC. Primary thymic carcinoma. Ann Thorac Surg. 2002;73:1076–81.

    Article  PubMed  Google Scholar 

  25. Rosado de Christenson ML, Abbott GF, Kirejczyk WM, Galvin JR, Travis WD. Thoracic carcinoids: radiologic-pathologic correlation. Radiographics. 1999;19:707–36.

    Article  CAS  PubMed  Google Scholar 

  26. Oshiro Y, Kusumoto M, Matsuno Y, et al. CT findings of surgically resected large cell neuroendocrine carcinoma of the lung in 38 patients. AJR Am J Roentgenol. 2004;182:87–91.

    Article  PubMed  Google Scholar 

  27. Modlin IM, Oberg K, Chung DC, et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9:61–72.

    Article  CAS  PubMed  Google Scholar 

  28. Sundin A, Vullierme MP, Kaltsas G, Plöckinger U, participants MCC, Society ENT. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: radiological examinations. Neuroendocrinology. 2009;90:167–83.

    Article  CAS  PubMed  Google Scholar 

  29. Fan Z, Li Y, Yan K, et al. Application of contrast-enhanced ultrasound in the diagnosis of solid pancreatic lesions-A comparison of conventional ultrasound and contrast-enhanced CT. Eur J Radiol. 2013;82:1385–90.

    Article  PubMed  Google Scholar 

  30. Wang SC, Parekh JR, Zuraek MB, et al. Identification of unknown primary tumors in patients with neuroendocrine liver metastases. Arch Surg. 2010;145:276–80.

    Article  PubMed  Google Scholar 

  31. Tan EH, Tan CH. Imaging of gastroenteropancreatic neuroendocrine tumors. World J Clin Oncol. 2011;2:28–43.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Eriksson B, Klöppel G, Krenning E, et al. Consensus guidelines for the management of patients with digestive neuroendocrine tumors--well-differentiated jejunal-ileal tumor/carcinoma. Neuroendocrinology. 2008;87:8–19.

    Article  CAS  PubMed  Google Scholar 

  33. Turaga KK, Kvols LK. Recent progress in the understanding, diagnosis, and treatment of gastroenteropancreatic neuroendocrine tumors. CA Cancer J Clin. 2011;61:113–32.

    Article  PubMed  Google Scholar 

  34. Rappeport ED, Hansen CP, Kjaer A, Knigge U. Multidetector computed tomography and neuroendocrine pancreaticoduodenal tumors. Acta Radiol. 2006;47:248–56.

    Article  CAS  PubMed  Google Scholar 

  35. Thoeni RF, Mueller-Lisse UG, Chan R, Do NK, Shyn PB. Detection of small, functional islet cell tumors in the pancreas: selection of MR imaging sequences for optimal sensitivity. Radiology. 2000;214:483–90.

    Article  CAS  PubMed  Google Scholar 

  36. Schmid-Tannwald C, Schmid-Tannwald CM, Morelli JN, et al. Comparison of abdominal MRI with diffusion-weighted imaging to 68Ga-DOTATATE PET/CT in detection of neuroendocrine tumors of the pancreas. Eur J Nucl Med Mol Imaging. 2013;40:897–907.

    Article  CAS  PubMed  Google Scholar 

  37. Minordi LM, Vecchioli A, Mirk P, Bonomo L. CT enterography with polyethylene glycol solution vs CT enteroclysis in small bowel disease. Br J Radiol. 2011;84:112–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Kamaoui I, De-Luca V, Ficarelli S, Mennesson N, Lombard-Bohas C, Pilleul F. Value of CT enteroclysis in suspected small-bowel carcinoid tumors. AJR Am J Roentgenol. 2010;194:629–33.

    Article  PubMed  Google Scholar 

  39. Van Weyenberg SJ, Meijerink MR, Jacobs MA, et al. MR enteroclysis in the diagnosis of small-bowel neoplasms. Radiology. 2010;254:765–73.

    Article  PubMed  Google Scholar 

  40. Owen NJ, Sohaib SA, Peppercorn PD, et al. MRI of pancreatic neuroendocrine tumours. Br J Radiol. 2001;74:968–73.

    Article  CAS  PubMed  Google Scholar 

  41. Waldmann J, Fendrich V, Habbe N, et al. Screening of patients with multiple endocrine neoplasia type 1 (MEN-1): a critical analysis of its value. World J Surg. 2009;33:1208–18.

    Article  PubMed  Google Scholar 

  42. Atkin W, Dadswell E, Wooldrage K, et al. Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial. Lancet. 2013;381:1194–202.

    Article  PubMed  Google Scholar 

  43. Pickhardt PJ, Hassan C, Halligan S, Marmo R. Colorectal cancer: CT colonography and colonoscopy for detection-systematic review and meta-analysis. Radiology. 2011;259:393–405.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Laghi A, Rengo M, Graser A, Iafrate F. Current status on performance of CT colonography and clinical indications. Eur J Radiol. 2013;82:1192–200.

    Article  PubMed  Google Scholar 

  45. Sahani DV, Bonaffini PA, Fernández-Del Castillo C, Blake MA. Gastroenteropancreatic neuroendocrine tumors: role of imaging in diagnosis and management. Radiology. 2013;266:38–61.

    Article  PubMed  Google Scholar 

  46. Chen L, Zhang J, Zhang L, et al. Meta-analysis of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging for the detection of liver metastases. PLoS One. 2012;7:e48681.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Attili F, Capurso G, Vanella G, et al. Diagnostic and therapeutic role of endoscopy in gastroenteropancreatic neoplasms. Dig Liver Dis. 2014;46:9–17.

    Article  PubMed  Google Scholar 

  48. van Tuyl SA, van Noorden JT, Timmer R, et al. Detection of small-bowel neuroendocrine tumors by video capsule endoscopy. Gastrointest Endosc. 2006;64:66–72.

    Article  PubMed  Google Scholar 

  49. Bellutti M, Fry LC, Schmitt J, et al. Detection of neuroendocrine tumors of the small bowel by double balloon enteroscopy. Dig Dis Sci. 2009;54:1050–8.

    Article  PubMed  Google Scholar 

  50. De Angelis C, Pellicano R, Rizzetto M, Repici A. Role of endoscopy in the management of gastroenteropancreatic neuroendocrine tumors. Minerva Gastroenterol Dietol. 2011;57:129–37.

    PubMed  Google Scholar 

  51. Schreiber G, McCrory D. Performance characteristics of different modalities for diagnosis of suspected lung cancer. Chest. 2003;123(suppl):115S–28S.

    Article  PubMed  Google Scholar 

  52. Varela-Lema L, Fernandez-Villar A, Ruano-Ravina A. Effectiveness and safety of endobronchial ultrasound-transbronchial needle aspiration: a systematic review. Eur Respir J. 2009;33:1156–64.

    Article  CAS  PubMed  Google Scholar 

  53. Nakajima T, Yasufuku K. How I do it—optimal methodology for multidirectional analysis of endobronchial ultrasound-guided transbronchial needle aspiration samples. J Thorac Oncol. 2011;6:203–6.

    Article  PubMed  Google Scholar 

  54. Modlin IM, Moss SF, Gustafsson BI, et al. The archaic distinction between functioning and nonfunctioning neuroendocrine neoplasms is no longer clinically relevant. Langenbeck’s Arch Surg. 2011;27:27.

    Google Scholar 

  55. Öberg K, Knigge U, Kwekkeboom D, et al. Neuroendocrine gastro-entero-pancreatic tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(Supplement 7):vii124–30.

    PubMed  Google Scholar 

  56. Kwekkeboom DJ, Krenning EP, Scheidhauer K, et al. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: SOMATOSTATIN receptor imaging with 111In-pentetreotide. Neuroendocrinology. 2009;90:184–9.

    Article  CAS  PubMed  Google Scholar 

  57. Bombardieri E, Ambrosini V, Aktolun C, et al. 111In-pentetreotide scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37:1441–8.

    Article  PubMed  Google Scholar 

  58. Kwekkeboom DJ, Krenning EP, Bakker WH, et al. Somatostatin analogue scintigraphy in carcinoid tumours. Eur J Nucl Med. 1993;20:283–92.

    Article  CAS  PubMed  Google Scholar 

  59. Krenning EP, Kwekkeboom DJ, Bakker WH, et al. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med. 1993;20:716–31.

    Article  CAS  PubMed  Google Scholar 

  60. Kwekkeboom DJ, Kam BL, van Essen M, et al. Somatostatin-receptor-based imaging and therapy of gastroenteropancreatic neuroendocrine tumors. Endocr Relat Cancer. 2010;17:R53–73.

    Article  CAS  PubMed  Google Scholar 

  61. Ambrosini V, Campana D, Bodei L, et al. 68Ga-DOTANOC PET/CT clinical impact in patients with neuroendocrine tumors. J Nucl Med. 2010;51:669–73.

    Article  PubMed  Google Scholar 

  62. Frilling A, Sotiropoulos GC, Radtke A, et al. The impact of 68Ga-DOTATOC positron emission tomography/computed tomography on the multimodal management of patients with neuroendocrine tumors. Ann Surg. 2010;252:850–6.

    Article  PubMed  Google Scholar 

  63. Virgolini I, Ambrosini V, Bomanji JB, et al. Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE. Eur J Nucl Med Mol Imaging. 2010;37:2004–10.

    Google Scholar 

  64. Jacobsson H, et al. Normal uptake of 68Ga-DOTA-TOC by the pancreas uncinate process mimicking malignancy at somatostatin receptor PET. Clin Nucl Med. 2012;37:362–5.

    Article  PubMed  Google Scholar 

  65. Castellucci P, Pou Ucha J, Fuccio C, et al. Incidence of increased 68Ga-DOTANOC uptake in the pancreatic head in a large series of extrapancreatic NET patients studied with sequential PET/CT. J Nucl Med. 2011;52:886–90.

    Article  PubMed  Google Scholar 

  66. Bunning J, Merchant SH, Crooks LA, et al. Indium-111 Pentetreotide uptake by pancreatic polypeptide cell hyperplasia. Pancreas. 2007;35:372–5.

    Article  PubMed  Google Scholar 

  67. Gabriel M, Decristoforo C, Kendler D, et al. 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med. 2007;48:508–18.

    Article  CAS  PubMed  Google Scholar 

  68. Skoura E, Michopoulou S, Mohmaduvesh M, Panagiotidis E, Al Harbi M, Toumpanakis C, Almukhailed O, Kayani I, Syed R, Navalkissoor S, Ell PJ, Caplin ME, Bomanji J. The Impact of 68Ga-DOTATATE PET/CT Imaging on Management of Patients with Neuroendocrine Tumors: Experience from a National Referral Center in the United Kingdom. J Nucl Med. 2016;57:34–40.

    Article  CAS  PubMed  Google Scholar 

  69. Montravers F, Grahek D, Kerrou K, et al. Can fluorodihydroxyphenylalanine PET replace somatostatin receptor scintigraphy in patients with digestive endocrine tumors? J Nucl Med. 2006;47:1455–62.

    CAS  PubMed  Google Scholar 

  70. Ambrosini V, Tomassetti P, Castellucci P, et al. Comparison between 68Ga-DOTA-NOC and 18F-DOPA PET for the detection of gastro-entero-pancreatic and lung neuro-endocrine tumours. Eur J Nucl Med Mol Imaging. 2008;35:1431–8.

    Article  CAS  PubMed  Google Scholar 

  71. Haug A, Auernhammer CJ, Wangler B, et al. Intraindividual comparison of 68Ga-DOTA-TATE and 18F-DOPA PET in patients with well-differentiated metastatic neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2009;36:765–70.

    Article  CAS  PubMed  Google Scholar 

  72. Binderup T, Knigge U, Loft A, et al. Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET. J Nucl Med. 2010;51:704–12.

    Article  PubMed  Google Scholar 

  73. Binderup T, Knigge U, Loft A, et al. 18F-fluorodeoxyglucose positron emission tomography predicts survival of patients with neuroendocrine tumors. Clin Cancer Res. 2010;16:978–85.

    Article  CAS  PubMed  Google Scholar 

  74. Srirajaskanthan R, Watkins J, Marelli L, Khan K, Caplin ME. Expression of somatostatin and dopamine 2 receptors in neuroendocrine tumours and the potential role for new biotherapies. Neuroendocrinology. 2009;89:308–14.

    Article  CAS  PubMed  Google Scholar 

  75. Oberg K, Kvols L, Caplin M, et al. Consensus report on the use of somatostatin analogs for the management of neuroendocrine tumors of the gastroenteropancreatic system. Ann Oncol. 2004;15:966–73.

    Article  CAS  PubMed  Google Scholar 

  76. Oberg K, Ferone D, Kaltsas G, Knigge UP, Taal B, Plöckinger U. ENETS consensus guidelines for the standards of care in neuroendocrine tumors: biotherapy. Neuroendocrinology. 2009;90:209–13.

    Article  PubMed  CAS  Google Scholar 

  77. Modlin IM, Pavel M, Kidd M, et al. Review article: somatostatin analogues in the treatment of gastroenteropancreatic neuroendocrine (carcinoid) tumours. Aliment Pharmacol Ther. 2010;31:169–88.

    CAS  PubMed  Google Scholar 

  78. Florio T. Molecular mechanisms of the antiproliferative activity of somatostatin receptors (SSTRs) in neuroendocrine tumors. Front Biosci. 2008;13:822–40.

    Article  CAS  PubMed  Google Scholar 

  79. Ferone D, et al. The clinical-molecular interface of somatostatin, dopamine and their receptors in pituitary pathophysiology. J Mol Endocrinol. 2009;42:361–70.

    Article  CAS  PubMed  Google Scholar 

  80. Ruscica M, et al. Somatostatin, somatostatin analogs and somatostatin receptor dynamics in the biology of cancer progression. Curr Mol Med. 2013;13:555–71.

    Article  CAS  PubMed  Google Scholar 

  81. Florio T, et al. Somatostatin inhibits tumor angiogenesis and growth via somatostatin receptor-3-mediated regulation of endothelial nitric oxide synthase and mitogen-activated protein kinase activities. Endocrinology. 2003;144:1574–84.

    Article  CAS  PubMed  Google Scholar 

  82. Panzuto F, Di Fonzo M, Iannicelli E, et al. Long-term clinical outcome of somatostatin analogues for treatment of progressive, metastatic, well-differentiated entero-pancreatic endocrine carcinoma. Ann Oncol. 2006;17:461–6.

    Article  CAS  PubMed  Google Scholar 

  83. De Dosso S, Bajetta E, Procopio G, et al. Pulmonary carcinoid tumours: indolent but not benign. Oncology. 2007;73:162–8.

    Article  PubMed  Google Scholar 

  84. Strosberg J, Gardner N, Kvols L. Survival and prognostic factor analysis of 146 metastatic neuroendocrine tumors of the mid-gut. Neuroendocrinology. 2009;89:471–6.

    Article  CAS  PubMed  Google Scholar 

  85. Rinke A, Muller HH, Schade-Brittinger C, et al. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID study group. J Clin Oncol. 2009;27:4656–63.

    Article  CAS  PubMed  Google Scholar 

  86. Caplin ME, et al. Lanreotide in metastatic enteropancreatic neuroendocrine tumors. N Engl J Med. 2014;371:224–33.

    Article  PubMed  CAS  Google Scholar 

  87. Rinke A, Wittenberg M, Schade-Brittinger C, Aminossadati B, Ronicke E, Gress TM, Müller HH, Arnold R, PROMID Study Group. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors (PROMID): results of Long-term survival. Neuroendocrinology. 2017;104:26–32.

    Article  CAS  PubMed  Google Scholar 

  88. Caplin ME, Pavel M, Ćwikła JB, Phan AT, Raderer M, Sedláčková E, Cadiot G, Wolin EM, Capdevila J, Wall L, Rindi G, Langley A, Martinez S, Gomez-Panzani E, Ruszniewski P, CLARINET Investigators. Anti-tumour effects of lanreotide for pancreatic and intestinal neuroendocrine tumours: the CLARINET open-label extension study. Endocr Relat Cancer. 2016;23:191–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Oberg K, et al. Neuroendocrine gastro-entero-pancreatic tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(Suppl7):vii124–30.

    PubMed  Google Scholar 

  90. Pavel M, et al. ENETS consensus guidelines update for the management of distant metastatic disease of intestinal, pancreatic, bronchial neuroendocrine neoplasms (NEN) and NEN of unknown primary site. Neuroendocrinology. 2016;103:172–85.

    Article  CAS  PubMed  Google Scholar 

  91. Pavel ME, Sers C. Women in cancer thematic review: systemic therapies in neuroendocrine tumors and novel approaches toward personalized medicine. Endocr Relat Cancer. 2016;23:T135–54.

    Article  PubMed  Google Scholar 

  92. Reubi JC, Laissue JA. Multiple actions of somatostatin in neoplastic disease. Trends Pharmacol Sci. 1995;16:110–5.

    Article  CAS  PubMed  Google Scholar 

  93. Reubi JC, et al. Subcellular distribution of somatostatin sst2A receptors in human tumors of the nervous and neuroendocrine systems: membranous versus intracellular location. J Clin Endocrinol Metab. 2000;85:3882–91.

    CAS  PubMed  Google Scholar 

  94. Kwekkeboom DJ, et al. Overview of results of peptide receptor radionuclide therapy with 3 radiolabeled somatostatin analogs. J Nucl Med. 2005;46(Suppl 1):62S–6S.

    CAS  PubMed  Google Scholar 

  95. Bodei L, et al. Peptide receptor therapies in neuroendocrine tumors. J Endocrinol Investig. 2009;32:360–9.

    Article  CAS  Google Scholar 

  96. Bodei L, et al. Radiolabeled somatostatin analogue therapy of gastroenteropancreatic cancer. Semin Nucl Med. 2016;46:225–38.

    Article  PubMed  Google Scholar 

  97. Ezziddin S, et al. Early prediction of tumour response to PRRT. The sequential change of tumour-absorbed doses during treatment with 177Lu-octreotate. Nuklearmedizin. 2013;52:170–7.

    Article  CAS  PubMed  Google Scholar 

  98. Brabander T, et al. Peptide receptor radionuclide therapy of neuroendocrine tumours. Best Pract Res Clin Endocrinol Metab. 2016;30:103–14.

    Article  CAS  PubMed  Google Scholar 

  99. Strosberg J. 6LBA 177-Lu-Dotatate significantly improves progression-free survival in patients with midgut neuroendocrine tumours: results of the phase III NETTER-1 trial. Eur J Cancer. 2015;51:S710.

    Article  Google Scholar 

  100. Kwekkeboom DJ, et al. Radiolabeled somatostatin analog [177Lu-DOTA0,Tyr3]octreotate in patients with endocrine gastroenteropancreatic tumors. J Clin Oncol. 2005;23:2754–62.

    Article  CAS  PubMed  Google Scholar 

  101. Campana D, et al. Radiolabelled somatostatin analogue treatment in gastroenteropancreatic neuroendocrine tumours: factors associated with response and suggestions for therapeutic sequence. Eur J Nucl Med Mol Imaging. 2013;40:1197–205.

    Article  CAS  PubMed  Google Scholar 

  102. Bodei L, et al. Long-term tolerability of PRRT in 807 patients with neuroendocrine tumours: the value and limitations of clinical factors. Eur J Nucl Med Mol Imaging. 2015;42:5–19.

    Article  CAS  PubMed  Google Scholar 

  103. Pavel ME, et al. Everolimus plus octreotide long-acting repeatable for the treatment of advanced neuroendocrine tumours associated with carcinoid syndrome (RADIANT-2): a randomised, placebo-controlled, phase 3 study. Lancet. 2011;378:2005–12.

    Article  CAS  PubMed  Google Scholar 

  104. Yao JC, et al. Everolimus for the treatment of advanced, non-functional neuroendocrine tumours of the lung or gastrointestinal tract (RADIANT-4): a randomised, placebo-controlled, phase 3 study. Lancet. 2016;387:968–77.

    Article  CAS  PubMed  Google Scholar 

  105. Yao JC, Shah MH, Ito T, et al. Everolimus for advanced pancreatic neuroendocrine tumors. N Engl J Med. 2011;364:514–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Raymond E, Dahan L, Raoul JL, et al. Sunitinib malate for the treatment of pancreatic neuroendocrine tumors. N Engl J Med. 2011;364:501–13.

    Article  CAS  PubMed  Google Scholar 

  107. Raymond E, Niccoli P, Raoul J, et al. Updated overall survival (OS) and progression-free survival (PFS) by blinded independent central review (BICR) of sunitinib (SU) versus placebo (PBO) for patients (Pts) with advanced unresectable pancreatic neuroendocrine tumors (NET). J Clin Oncol. 2011;29(suppl):4008. abstr

    Article  Google Scholar 

  108. Moertel CG, Kvols LK, O’Connel MJ. Treatment of neuroendocrine carcinomas with combined etoposide and cisplatin. Cancer. 1991;68:227–32.

    Article  CAS  PubMed  Google Scholar 

  109. Mitry E, Baudin E, Ducreaux M, et al. Treatment of poorly differentiated neuroendocrine tumours with etoposide and cisplatin. Br J Cancer. 1999;81:1351–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Iwasa S, Morizane C, Okusaka T, et al. Cisplatin and etoposide as first-line chemotherapy for poorly differentiated neuroendocrine carcinoma of the hepatobiliary tract and pancreas. Jpn J Clin Oncol. 2010;40:313–8.

    Article  PubMed  Google Scholar 

  111. Sorbye H, Welin S, Langer SW, Vestermark LW, Holt N, Osterlund P, Dueland S, Hofsli E, Guren MG, Ohrling K, Birkemeyer E, Thiis-Evensen E, Biagini M, Gronbaek H, Soveri LM, Olsen IH, Federspiel B, Assmus J, Janson, Knigge U. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study. Ann Oncol. 2013;24:152–60.

    Google Scholar 

  112. Garcia-Carbonero R, Sorbye H, Baudin E, Raymond E, Wiedenmann B, Niederle B, Sedlackova E, Toumpanakis C, Anlauf M, Cwikla JB, Caplin M, O’Toole D, Perren A. ENETS consensus guidelines for high-grade gastroenteropancreatic neuroendocrine tumors and neuroendocrine carcinomas. Neuroendocrinology. 2016;103:186–94.

    Article  CAS  PubMed  Google Scholar 

  113. Lu ZH, Li J, Lu N, et al. Feasibility and efficacy of combined cisplatin plus irinotecan chemotherapy for gastroenteropancreatic neuroendocrine carcinomas. Med Oncol. 2013;30:664.

    Article  CAS  PubMed  Google Scholar 

  114. Welin S, Sorbye H, Sebjornsen S, Knappskog S, Busch C, Oberg K. Clinical effect of temozolomide-based chemotherapy in poorly differentiated endocrine carcinoma after progression on first-line chemotherapy. Cancer. 2011;117:4617–22.

    Article  CAS  PubMed  Google Scholar 

  115. Fine RL, Gulati AP, Krantz BA, Moss RA, Schreibman S, Tsushima DA, Mowatt KB, Dinnen RD, Mao Y, Stevens PD, Schrope B, Allendorf J, Lee JA, Sherman WH, Chabot JA. Capecitabine and temozolomide (CAPTEM) for metastatic, well-differentiated neuroendocrine cancers: The Pancreas Center at Columbia University experience. Cancer Chemother Pharmacol. 2013;71:663–70.

    Article  CAS  PubMed  Google Scholar 

  116. Strosberg JR, Fine RL, Choi J, Nasir A, Coppola D, Chen DT, Helm J, Kvols L. First-line chemotherapy with capecitabine and temozolomide in patients with metastatic pancreatic endocrine carcinomas. Cancer. 2011;117:268–75.

    Article  CAS  PubMed  Google Scholar 

  117. Kulke MH, et al. O6-methylguanine DNA methyltransferase deficiency and response to temozolomide-based therapy in patients with neuroendocrine tumors. Clin Cancer Res. 2009;15:338–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  118. Ekeblad S, et al. Temozolomide as monotherapy is effective in treatment of advanced malignant neuroendocrine tumors. Clin Cancer Res. 2007;13:2986–91.

    Article  CAS  PubMed  Google Scholar 

  119. Walter T, et al. O6-Methylguanine-DNA methyltransferase status in neuroendocrine tumours: prognostic relevance and association with response to alkylating agents. Br J Cancer. 2015;112:523–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  120. Pignon JP, Arriagada R, Ihde DC, et al. A meta-analysis of thoracic radiotherapy for small cell lung cancer. N Engl J Med. 1992;327:1618–24.

    Article  CAS  PubMed  Google Scholar 

  121. Warde P, Payne D. Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. J Clin Oncol. 1992;10:890–5.

    Article  CAS  PubMed  Google Scholar 

  122. Sundstrom S, Bremnes RM, Kaasa S, et al. Cisplatin and etoposide regimen is superior to cyclophosphamide, epirubicin and vincristine regimen in small-cell lung cancer: results from a randomized phase III trial with 5 years’ follow-up. J Clin Oncol. 2002;20:4665–72.

    Article  CAS  PubMed  Google Scholar 

  123. Iyoda A, Hiroshima K, Moriya Y, et al. Prospective study of adjuvant chemotherapy for pulmonary large cell neuroendocrine carcinoma. Ann Thorac Surg. 2006;82:1802–7.

    Article  PubMed  Google Scholar 

  124. Noda K, Nishiwaki Y, Kawahara M, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med. 2002;346:85–91.

    Article  CAS  PubMed  Google Scholar 

  125. Hanna N, Bunn PA Jr, Langer C, et al. Randomized phase III trial comparing irinotecan/cisplatin with etoposide/cisplatin in patients with previously untreated extensive-stage disease small-cell lung cancer. J Clin Oncol. 2006;24:2038–43.

    Article  CAS  PubMed  Google Scholar 

  126. Lara PN, Natale RB, Crowley J, et al. Phase III trial of irinotecan/cisplatin compared with etoposide/cisplatin in extensive-stage small-cell lung cancer: clinical and pharmacogenomic results from SWOG S0124. J Clin Oncol. 2009;27:2530–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  127. Sun JM, Ahn MJ, Ahn JS, et al. Chemotherapy for pulmonary large cell neuroendocrine carcinoma: similar to that for small cell lung cancer or non-small cell lung cancer? Lung Cancer. 2012;77:365–70.

    Article  PubMed  Google Scholar 

  128. Le Treut J, Sault MC, Lena H, et al. Multicentre phase II study of cisplatin-etoposide chemotherapy for advanced large-cell neuroendocrine lung carcinoma: the GFPC 0302 study. Ann Oncol. 2013;24:1548–52.

    Article  PubMed  Google Scholar 

  129. Caplin ME, Baudin E, Ferolla P, Filosso P, Garcia-Yuste M, Lim E, Oberg K, Pelosi G, Perren A, Rossi RE, Travis WD. Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol. 2015;26:1604–20.

    Article  CAS  PubMed  Google Scholar 

  130. Lim E, Goldstraw P, Nicholson G, Travis WD, Jett JR, Ferolla P, Bomaji J, Rusch VW, Asamura H, Skogseid B, Baudin EE, Caplin M, Kwekkwboom D, Brambilla E, Crowley J. Proceedings of the IASLC International Workshop on advances in pulmonary neuroendocrine tumors 2007. J Thorac Oncol. 2008;3:1194–201.

    Article  PubMed  Google Scholar 

  131. Crona J, Fanola I, Lindholm DP, Antonodimitrakis P, Oberg K, Granberg D. Effect of temozolomide in patients with metastatic bronchial carcinoids. Neuroendocrinology. 2013;98:151–5.

    Article  CAS  PubMed  Google Scholar 

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Ferone, D. et al. (2018). Neuroendocrine Tumours: Diagnosis, Therapy and Follow-up. In: Giovanella, L. (eds) Atlas of Thyroid and Neuroendocrine Tumor Markers. Springer, Cham. https://doi.org/10.1007/978-3-319-62506-5_14

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