Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are the most common form of neuroendocrine neoplasia, but there is no current consensus for the sequencing of approved therapies, particularly with respect to peptide receptor radionuclide therapy (PRRT). This comprehensive review evaluates the data supporting approved therapies for GEP-NETs and recommendations for therapeutic sequencing with a focus on how PRRT currently fits within sequencing algorithms. The current recommendations for PRRT sequencing restrict its use to metastatic, inoperable, progressive midgut NETs, however, this may change with emerging data to suggest PRRT might be beneficial as neoadjuvant therapy for inoperable tumors, is more tolerable than other treatment modalities following first-line standard dose somatostatin analogues, and can be used as salvage therapy after disease relapse following prior successful cycles of PRRT. PRRT has also been shown to reduce tumor burden, improve quality of life, and prolong the time to disease progression in a broad spectrum of patients with GEP-NETs. As the various potential benefits of PRRT in GEP-NET therapy continues to expand, it is necessary to review and critically evaluate our treatment algorithms for GEP-NETs.


中文翻译：

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PRRT的状态及其在胃肠胰腺神经内分泌肿瘤当前治疗方案中的排序

胃肠胰神经内分泌肿瘤 (GEP-NETs) 是最常见的神经内分泌肿瘤形式，但目前对于已批准治疗的排序尚无共识，特别是在肽受体放射性核素治疗 (PRRT) 方面。这篇全面的综述评估了支持 GEP-NETs 批准疗法的数据和治疗测序的建议，重点是 PRRT 当前如何适合测序算法。目前对 PRRT 测序的建议将其用于转移性、不可手术、进行性中肠 NET，然而，这可能会随着新数据的变化而改变，表明 PRRT 可能是有益的，因为对于不可手术的肿瘤的新辅助治疗，比一线后的其他治疗方式更容易耐受标准剂量的生长抑素类似物，并且可以在先前成功的 PRRT 周期后疾病复发后用作补救治疗。PRRT 还被证明可以减轻广泛的 GEP-NET 患者的肿瘤负担、提高生活质量并延长疾病进展时间。随着 PRRT 在 GEP-NET 治疗中的各种潜在益处不断扩大，有必要审查和严格评估我们的 GEP-NET 治疗算法。