Systemic Treatment of Advanced Gastroenteropancreatic Neuroendocrine Tumors in Korea: Literature Review and Expert Opinion

Abstract

Neuroendocrine tumors (NETs) are a group of malignancies arising from neuroendocrine cells and frequently originate in the gastrointestinal tract and pancreas. Although curative resection is the main treatment for localized disease, systemic therapy is needed for relapsed or metastatic/unresectable gastroenteropancreatic NETs (GEP-NETs). Although there are several NET treatment guidelines from various countries, the geographical discrepancies between patient clinical characteristics, the regulatory approval status for therapeutic agents, and medical practices necessitate specific guidelines for Korean patients. We here provide a consensus review of the diagnosis, staging and systemic treatment of Korean GEP-NET patients. Systemic therapy options and the current Korean expert consensus on these treatments, including somatostatin analogs, targeted therapies such as everolimus and sunitinib, peptide receptor radionuclide treatments, and cytotoxic chemotherapies are addressed.

Keywords: Capecitabine; Everolimus; Lanreotide; Neuroendocrine tumor; Octreotide; Peptide receptor radionuclide therapy; Sunitinib.

Fig. 1

The recommended approach of systemic therapy for advanced gastroenteropancreatic neuroendocrine tumors (NETs). CAPTEM, capecitabine plus temozolomide; NEC, neuroendocrine carcinoma; PRRT, peptide receptor radionuclide therapy; SSTR, somatostatin receptor.