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Review
. 2023 Sep;37(5):101794.
doi: 10.1016/j.beem.2023.101794. Epub 2023 Jun 28.

Precision medicine in gastroenteropancreatic neuroendocrine neoplasms: Where are we in 2023?

Affiliations
Review

Precision medicine in gastroenteropancreatic neuroendocrine neoplasms: Where are we in 2023?

Nicola Fazio et al. Best Pract Res Clin Endocrinol Metab. 2023 Sep.

Abstract

Precision medicine describes a target-related approach to tailoring diagnosis and treatment of the individual patient. While this personalized approach is revoluzionizing many areas of oncology, it is quite late in the field of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), in which there are few molecular alterations to be therapeutically targeted. We critically reviewed the current evidence about precision medicine in GEP NENs, focusing on potential clinically relevant actionable targets for GEP NENs, such as the mTOR pathway, MGMT, hypoxia markers, RET, DLL-3, and some general agnostic targets. We analysed the main investigational approaches with solid and liquid biopsies. Furthermore, we reviewed a model of precision medicine more specific for NENs that is the theragnostic use of radionuclides. Overall, currently no true predictive factors for therapy have been validated so far in GEP NENs, and the personalized approach is based more on clinical thinking within a NEN-dedicated multidisciplinary team. However, there is a robust background to suppose that precision medicine, with the theragnostic model will yield new insights in this context soon.

Keywords: GEP-NENs; Precision medicine; actionable tissue targets; liquid biopsy; theragnostics.

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Conflict of interest statement

Declaration of Competing Interest A.L.S. have no conflict of interests to declare. N.F. has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AAA, Ipsen, Sanofi, Merck and has participated on a data safety Monitoring Board or Advisory Board of AAA, HutchMed, Merck, Novartis and MSD.

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