| Theme | Diversified Modalities of Liver Metastasis Treatment | |
|---|---|---|
| Title | Liver Metastases Arising from Gastroenteropancreatic Neuroendocrine Tumors | |
| Publish Date | 2011/04 | |
| Author | Koji Tezuka | Department of Gastroenterological, Breast, Thyroid and General Surgery, Yamagata University Faculty of Medicine |
| Author | Ichiro Hirai | Department of Gastroenterological, Breast, Thyroid and General Surgery, Yamagata University Faculty of Medicine |
| Author | Wataru Kimura | Department of Gastroenterological, Breast, Thyroid and General Surgery, Yamagata University Faculty of Medicine |
| [ Summary ] | Gastroenteropancreatic neuroendocrine tumors (GEPNETs) are primarily slow glowing tumors and should be managed operatively as a first-line therapy. Unresectable liver metastases are managed with medical treatment. Somatostatin analogues can reduce hormone-related symptoms and are thought to induce tumor growth stabilization. Streptozotocin-based combination therapyis performed for metastatic well-differentiated neuroendocrine carcinoma with high proliferating activity, which is refractory to somatostatin analogues. Cisplatin-based combination therapyis performed as a first-line chemotherapyfor metastatic poorly-differentiated neuroendocrine carcinomas. Recently, favorable response rates and survival benefits from peptide receptor radionuclide therapyhave been reported. Clinical trials of various molecular targeted therapy such as the multi-tyrosine kinase inhibitor sunitinib and the mTOR inhibitor everolimus have been conducted in Western countries. Further developments in medical treatment and diagnostic modalities are expected in Japan. |
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