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 journalArticle

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

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Neoplasms
Professional Competence
Medical Oncology
Patient Preference
Therapeutics
Disease Progression
Comorbidity
Costs and Cost Analysis
Recurrence
Endocrinologists
methylamphotericin B

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

Cite this

Assessment of response to treatment and follow-up in gastroenteropancreatic neuroendocrine neoplasms. / Grimaldi, F.; Fazio, N.; Attanasio, R.; Frasoldati, A.; Papini, E.; Cremonini, N.; Davì, M.V.; Funicelli, L.; Massironi, S.; Spada, F.; Toscano, V.; Versari, A.; Zini, M.; Falconi, M.; Öberg, K.

In: Endocrine, Metabolic and Immune Disorders - Drug Targets, Vol. 18, No. 5, 2018, p. 419-449.

Research output: Contribution to journalArticle

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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. {\circledC} 2018 Bentham Science Publishers.",
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",
author = "F. Grimaldi and N. Fazio and R. Attanasio and A. Frasoldati and E. Papini and N. Cremonini and M.V. Dav{\`i} and L. Funicelli and S. Massironi and F. Spada and V. Toscano and A. Versari and M. Zini and M. Falconi and K. {\"O}berg",
note = "Export Date: 5 February 2019 Correspondence Address: Grimaldi, F.; Azienda Sanitaria Universitaria Integrata di Udine, Piazzale Santa Maria della MisericordiaItaly; email: franco.grimaldi@asuiud.sanita.fvg.it Chemicals/CAS: 5 hydroxyindoleacetic acid, 1321-73-9, 54-16-0; calcium, 7440-70-2, 14092-94-5; carboplatin, 41575-94-4; cisplatin, 15663-27-1, 26035-31-4, 96081-74-2; etoposide, 33419-42-0, 433304-61-1; everolimus, 159351-69-6; fluorodeoxyglucose f 18, 63503-12-8; gastrin, 9002-76-0; growth hormone, 36992-73-1, 37267-05-3, 66419-50-9, 9002-72-6; insulin, 9004-10-8; oxaliplatin, 61825-94-3; parathyroid hormone, 12584-96-2, 68893-82-3, 9002-64-6; pentetreotide, 138661-02-6; phosphate, 14066-19-4, 14265-44-2; prolactin, 12585-34-1, 50647-00-2, 9002-62-4; somatomedin C, 67763-96-6; streptozocin, 18883-66-4; sunitinib, 341031-54-7, 557795-19-4; telotristat ethyl, 1033805-22-9; vasoactive intestinal polypeptide, 37221-79-7; Antineoplastic Agents Tradenames: octreoscan References: Klimstra, D.S., Modlin, I.R., Coppola, D., Lloyd, R.V., Suster, S., The pathologic classification of neuroendocrine tumors: A review of nomenclature, grading, and staging systems (2010) Pancreas, 39, pp. 707-712. , no LoE; Rindi, G., Arnold, R., Capella, C., Nomenclature and classification of neuroendocrine neoplasms of the digestive system (2010) WHO Classification of Tumours of the Digestive System, pp. 10-12. , 4th ed; Bosman, T.F.; Carneiro, F.; Hruban, R.H.; Theise, N.D. 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year = "2018",
doi = "10.2174/1871530318666171213145803",
language = "English",
volume = "18",
pages = "419--449",
journal = "Endocrine, Metabolic and Immune Disorders - Drug Targets",
issn = "1871-5303",
publisher = "Bentham Science Publishers B.V.",
number = "5",

}

TY - JOUR

T1 - Assessment of response to treatment and follow-up in gastroenteropancreatic neuroendocrine neoplasms

AU - Grimaldi, F.

AU - Fazio, N.

AU - Attanasio, R.

AU - Frasoldati, A.

AU - Papini, E.

AU - Cremonini, N.

AU - Davì, M.V.

AU - Funicelli, L.

AU - Massironi, S.

AU - Spada, F.

AU - Toscano, V.

AU - Versari, A.

AU - Zini, M.

AU - Falconi, M.

AU - Öberg, K.

N1 - Export Date: 5 February 2019 Correspondence Address: Grimaldi, F.; Azienda Sanitaria Universitaria Integrata di Udine, Piazzale Santa Maria della MisericordiaItaly; email: franco.grimaldi@asuiud.sanita.fvg.it Chemicals/CAS: 5 hydroxyindoleacetic acid, 1321-73-9, 54-16-0; calcium, 7440-70-2, 14092-94-5; carboplatin, 41575-94-4; cisplatin, 15663-27-1, 26035-31-4, 96081-74-2; etoposide, 33419-42-0, 433304-61-1; everolimus, 159351-69-6; fluorodeoxyglucose f 18, 63503-12-8; gastrin, 9002-76-0; growth hormone, 36992-73-1, 37267-05-3, 66419-50-9, 9002-72-6; insulin, 9004-10-8; oxaliplatin, 61825-94-3; parathyroid hormone, 12584-96-2, 68893-82-3, 9002-64-6; pentetreotide, 138661-02-6; phosphate, 14066-19-4, 14265-44-2; prolactin, 12585-34-1, 50647-00-2, 9002-62-4; somatomedin C, 67763-96-6; streptozocin, 18883-66-4; sunitinib, 341031-54-7, 557795-19-4; telotristat ethyl, 1033805-22-9; vasoactive intestinal polypeptide, 37221-79-7; Antineoplastic Agents Tradenames: octreoscan References: Klimstra, D.S., Modlin, I.R., Coppola, D., Lloyd, R.V., Suster, S., The pathologic classification of neuroendocrine tumors: A review of nomenclature, grading, and staging systems (2010) Pancreas, 39, pp. 707-712. , no LoE; Rindi, G., Arnold, R., Capella, C., Nomenclature and classification of neuroendocrine neoplasms of the digestive system (2010) WHO Classification of Tumours of the Digestive System, pp. 10-12. , 4th ed; Bosman, T.F.; Carneiro, F.; Hruban, R.H.; Theise, N.D. 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(Orlando), 28, pp. 126-133. , (no LoE); Valle, J.W., Faivre, S., Hubner, R.A., Grande, E., Raymond, E., Practical management of sunitinib toxicities in the treatment of pancreatic neuroendocrine tumors (2014) Cancer Treat. Rev., 40, pp. 1230-1238. , no LoE; Ezziddin, S., Attassi, M., Yong-Hing, C.J., Ahmadzadehfar, H., Willinek, W., Grünwald, F., Guhlke, S., Sabet, A., Predictors of long-term outcome in patients with well-differentiated gastroenteropancreatic neuroendocrine tumors after peptide receptor radionuclide therapy with177Lu-octreotate (2014) J. Nucl. Med., 55, pp. 183-190; Garin, E., Le Jeune, F., Devillers, A., Cuggia, M., de Lajarte-Thirouard, A.-S., Bouriel, C., Boucher, E., Raoul, J.-L., Predictive value of18F-FDG PET and somatostatin receptor scintigraphy in patients with metastatic endocrine tumors (2009) J. Nucl. Med., 50, pp. 858-864. , (LoE ⊗⊗⃝⃝); Severi, S., Nanni, O., Bodei, L., Sansovini, M., Ianniello, A., Nicoletti, S., Scarpi, E., Paganelli, G., Role of18FDG PET/CT in patients treated with177Lu-DOTATATE for advanced differentiated neuroendocrine tumours (2013) Eur. J. Nucl. Med. Mol. Imaging, 40, pp. 881-888. , (LoE ⊗⊗⃝⃝)

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

KW - Carcinoid syndrome

KW - Criteria of response

KW - Gastrinoma

KW - Imaging

KW - Insulinoma

KW - Markers

KW - NEN

KW - NET follow-up

KW - Neuroendocrine tumors

KW - Non-functioning NET

KW - 5 hydroxyindoleacetic acid

KW - albumin corrected calcium

KW - calcium

KW - carboplatin

KW - chromogranin A

KW - cisplatin

KW - contrast medium

KW - etoposide

KW - everolimus

KW - fluorodeoxyglucose f 18

KW - gadoexetic acid

KW - gallium dotatate ga 68

KW - gastrin

KW - growth hormone

KW - insulin

KW - interferon

KW - neuron specific enolase

KW - oxaliplatin

KW - parathyroid hormone

KW - pentetreotide

KW - phosphate

KW - prolactin

KW - radioisotope

KW - somatomedin C

KW - somatostatin derivative

KW - streptozocin

KW - sunitinib

KW - telotristat ethyl

KW - tumor marker

KW - unclassified drug

KW - unindexed drug

KW - vasoactive intestinal polypeptide

KW - antineoplastic agent

KW - ablation therapy

KW - advanced cancer

KW - arterial embolization

KW - Article

KW - bronchoconstriction

KW - cancer combination chemotherapy

KW - cancer growth

KW - cancer of unknown primary site

KW - cancer radiotherapy

KW - cancer recurrence

KW - cancer size

KW - cancer staging

KW - cancer surgery

KW - cancer survival

KW - carcinoid syndrome

KW - cardiologist

KW - chemoembolization

KW - clinical feature

KW - clinical practice

KW - colonoscopy

KW - comorbidity

KW - diarrhea

KW - disease free survival

KW - disease surveillance

KW - eastern cooperative oncology group score

KW - echocardiography

KW - endoscopic polypectomy

KW - endoscopic retrograde cholangiopancreatography

KW - endoscopic submucosal dissection

KW - endoscopic surgery

KW - endoscopic ultrasonography

KW - european organization for research and treatment of cancer criteria

KW - evidence based practice

KW - flow rate

KW - flushing

KW - follow up

KW - functional assessment

KW - functional assessment of cancer therapy

KW - functional status

KW - gastrin blood level

KW - gastrinoma

KW - gastroenteropancreatic neuroendocrine tumor

KW - gastrointestinal endoscopy

KW - gastrointestinal hemorrhage

KW - genetic disorder

KW - global health

KW - health care cost

KW - human

KW - image guided biopsy

KW - insulinoma

KW - jaundice

KW - Karnofsky Performance Status

KW - liver metastasis

KW - lymph node dissection

KW - molecularly targeted therapy

KW - multidisciplinary team

KW - nephrotoxicity

KW - nuclear magnetic resonance imaging

KW - objective tumor response

KW - pancreas islet cell tumor

KW - pancreatic incidentaloma

KW - pathology

KW - patient preference

KW - patient referral

KW - peptide receptor radionuclide therapy

KW - positron emission tomography response criteria in solid tumors

KW - positron emission tomography-computed tomography

KW - practice guideline

KW - progression free survival

KW - quality of life

KW - radiation exposure

KW - radical resection

KW - radioembolization

KW - radioisotope therapy

KW - response evaluation criteria in solid tumors

KW - risk assessment

KW - risk benefit analysis

KW - scoring system

KW - surgical margin

KW - systemic therapy

KW - transthoracic echocardiography

KW - treatment failure

KW - treatment planning

KW - treatment response

KW - upper abdominal pain

KW - wheezing

KW - whole body CT

KW - Zollinger Ellison syndrome

KW - carcinoma

KW - clinical decision making

KW - consensus

KW - decision support system

KW - diagnostic imaging

KW - gastrointestinal tumor

KW - Italy

KW - oncology

KW - pancreas tumor

KW - patient selection

KW - predictive value

KW - risk factor

KW - standards

KW - time factor

KW - treatment outcome

KW - Antineoplastic Agents

KW - Carcinoma, Neuroendocrine

KW - Clinical Decision-Making

KW - Consensus

KW - Decision Support Techniques

KW - Gastrointestinal Neoplasms

KW - Humans

KW - Medical Oncology

KW - Pancreatic Neoplasms

KW - Patient Selection

KW - Predictive Value of Tests

KW - Risk Factors

KW - Time Factors

KW - Treatment Outcome

U2 - 10.2174/1871530318666171213145803

DO - 10.2174/1871530318666171213145803

M3 - Article

VL - 18

SP - 419

EP - 449

JO - Endocrine, Metabolic and Immune Disorders - Drug Targets

JF - Endocrine, Metabolic and Immune Disorders - Drug Targets

SN - 1871-5303

IS - 5

ER -