Molecular Pathogenesis of Neuroendocrine Tumors: Implications for Current and Future Therapeutic Approaches
Cet article passe en revue les perspectives offertes par les travaux récents sur la biologie des tumeurs neuroendocrines pour le diagnostic de la maladie et le traitement des patients
The treatment landscape and biological understanding of neuroendocrine tumors (NETs) has shifted dramatically in recent years. Recent studies have shown that somatostatin analogs have the potential to not only control symptoms of hormone hypersecretion, but also have the ability to slow tumor growth in patients with advanced carcinoid. The results of clinical trials have further shown that the vascular endothelial growth factor (VEGF) pathway inhibitor sunitinib and the mammalian target of rapamycin (mTOR) inhibitor everolimus have efficacy in patients with advanced pancreatic NETs. The efficacy of these targeted therapies in NET suggests that the molecular characterization of NETs may provide an avenue to both predict which patients may most benefit from treatment and to overcome potential drug resistance. Recent genomic studies of NETs have further suggested that pathways regulating chromatin remodeling and epigenetic modification may play a key role in regulating NET growth. These observations offer the potential for new therapeutic and diagnostic advances for patients with NET.