Assessment of response to treatment and follow-up in gastroenteropancreatic neuroendocrine neoplasms

F. Grimaldi, N. Fazio, R. Attanasio, A. Frasoldati, E. Papini, N. Cremonini, M.V. Davì, L. Funicelli, S. Massironi, F. Spada, V. Toscano, A. Versari, M. Zini, M. Falconi, K. Öberg

Research output: Contribution to journalArticlepeer-review

Abstract

Well-established criteria for evaluating the response to treatment and the appropriate follow-up of individual patients are critical in clinical oncology. The current evidence-based data on these issues in terms of the management of gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN) are unfortunately limited. This document by the Italian Association of Clinical Endocrinologists (AME) on the criteria for the follow-up of GEP-NEN patients is aimed at providing comprehensive recommendations for everyday clinical practice based on both the best available evidence and the combined opinion of an interdisciplinary panel of experts. The initial risk stratification of patients with NENs should be performed according to the grading, staging and functional status of the neoplasm and the presence of an inherited syndrome. The evaluation of response to the initial treatment, and to the subsequent therapies for disease progression or recurrence, should be based on a cost-effective, risk-effective and timely use of the appropriate diagnostic resources. A multidisciplinary evaluation of the response to the treatment is strongly recommended and, at every step in the follow-up, it is mandatory to assess the disease state and the patient performance status, comorbidities, and recent clinical evolution. Local expertise, available technical resources and the patient preferences should always be evaluated while planning the individual clinical management of GEP-NENs. © 2018 Bentham Science Publishers.
Original languageEnglish
Pages (from-to)419-449
Number of pages31
JournalEndocrine, Metabolic and Immune Disorders - Drug Targets
Volume18
Issue number5
DOIs
Publication statusPublished - 2018

Keywords

  • Carcinoid syndrome
  • Criteria of response
  • Gastrinoma
  • Imaging
  • Insulinoma
  • Markers
  • NEN
  • NET follow-up
  • Neuroendocrine tumors
  • Non-functioning NET
  • 5 hydroxyindoleacetic acid
  • albumin corrected calcium
  • calcium
  • carboplatin
  • chromogranin A
  • cisplatin
  • contrast medium
  • etoposide
  • everolimus
  • fluorodeoxyglucose f 18
  • gadoexetic acid
  • gallium dotatate ga 68
  • gastrin
  • growth hormone
  • insulin
  • interferon
  • neuron specific enolase
  • oxaliplatin
  • parathyroid hormone
  • pentetreotide
  • phosphate
  • prolactin
  • radioisotope
  • somatomedin C
  • somatostatin derivative
  • streptozocin
  • sunitinib
  • telotristat ethyl
  • tumor marker
  • unclassified drug
  • unindexed drug
  • vasoactive intestinal polypeptide
  • antineoplastic agent
  • ablation therapy
  • advanced cancer
  • arterial embolization
  • Article
  • bronchoconstriction
  • cancer combination chemotherapy
  • cancer growth
  • cancer of unknown primary site
  • cancer radiotherapy
  • cancer recurrence
  • cancer size
  • cancer staging
  • cancer surgery
  • cancer survival
  • carcinoid syndrome
  • cardiologist
  • chemoembolization
  • clinical feature
  • clinical practice
  • colonoscopy
  • comorbidity
  • diarrhea
  • disease free survival
  • disease surveillance
  • eastern cooperative oncology group score
  • echocardiography
  • endoscopic polypectomy
  • endoscopic retrograde cholangiopancreatography
  • endoscopic submucosal dissection
  • endoscopic surgery
  • endoscopic ultrasonography
  • european organization for research and treatment of cancer criteria
  • evidence based practice
  • flow rate
  • flushing
  • follow up
  • functional assessment
  • functional assessment of cancer therapy
  • functional status
  • gastrin blood level
  • gastrinoma
  • gastroenteropancreatic neuroendocrine tumor
  • gastrointestinal endoscopy
  • gastrointestinal hemorrhage
  • genetic disorder
  • global health
  • health care cost
  • human
  • image guided biopsy
  • insulinoma
  • jaundice
  • Karnofsky Performance Status
  • liver metastasis
  • lymph node dissection
  • molecularly targeted therapy
  • multidisciplinary team
  • nephrotoxicity
  • nuclear magnetic resonance imaging
  • objective tumor response
  • pancreas islet cell tumor
  • pancreatic incidentaloma
  • pathology
  • patient preference
  • patient referral
  • peptide receptor radionuclide therapy
  • positron emission tomography response criteria in solid tumors
  • positron emission tomography-computed tomography
  • practice guideline
  • progression free survival
  • quality of life
  • radiation exposure
  • radical resection
  • radioembolization
  • radioisotope therapy
  • response evaluation criteria in solid tumors
  • risk assessment
  • risk benefit analysis
  • scoring system
  • surgical margin
  • systemic therapy
  • transthoracic echocardiography
  • treatment failure
  • treatment planning
  • treatment response
  • upper abdominal pain
  • wheezing
  • whole body CT
  • Zollinger Ellison syndrome
  • carcinoma
  • clinical decision making
  • consensus
  • decision support system
  • diagnostic imaging
  • gastrointestinal tumor
  • Italy
  • oncology
  • pancreas tumor
  • patient selection
  • predictive value
  • risk factor
  • standards
  • time factor
  • treatment outcome
  • Antineoplastic Agents
  • Carcinoma, Neuroendocrine
  • Clinical Decision-Making
  • Consensus
  • Decision Support Techniques
  • Gastrointestinal Neoplasms
  • Humans
  • Medical Oncology
  • Pancreatic Neoplasms
  • Patient Selection
  • Predictive Value of Tests
  • Risk Factors
  • Time Factors
  • Treatment Outcome

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