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Gastroenteropankreatische neuroendokrine Neoplasien (GEP-NEN)

Leitliniengerechte medikamentöse Therapie

Gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN)

Guideline-compliant medicinal therapy

  • Schwerpunkt: Neuroendokrine Tumoren
  • Published:
Der Gastroenterologe Aims and scope

Zusammenfassung

Dieser Beitrag gibt einen Überblick über die leitliniengerechte Therapie gastroenteropankreatischer neuroendokriner Neoplasien (GEP-NEN). Vorgestellt werden zunächst die verschiedenen Einsatzbereiche der Biotherapie. Als Biotherapie wird eine medikamentöse Behandlung mit Hormonanaloga wie Somatostatinanaloga (SSA) oder Interferon alfa bezeichnet. Der Stellenwert der systemischen Chemotherapie wird bei extrapankreatischen Primärtumoren abhängig von deren Lokalisation sehr unterschiedlich bewertet. Bei pankreatischen NEN wird die Chemotherapie empfohlen, wenn unter Biotherapie ein Progress aufgetreten ist. Im Weiteren wird die aktuelle Daten- und Empfehlungslage hinsichtlich des Einsatzes der modernen molekular-zielgerichteten („targeted therapies“) beleuchtet. Hier sind mittlerweile zwei Wirkstoffe (Everolimus und Sunitinib) zur Behandlung pankreatischer NEN zugelassen. Bei anderen Primärtumorlokalisationen ist der Nutzen der neuen molekular-zielgerichteten Substanzen noch nicht vollständig geklärt. Abschließend werden kurz die Möglichkeiten der antiresorptiven Therapie bei Knochenmetastasen erörtert.

Abstract

This article gives an overview of the guideline-compliant therapy of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). Firstly, the various fields of application of biologics therapy are presented. A biologic therapy involves a medicinal treatment with homone analogs, such as somatostatin analogs (SAS) and interferon alpha. The importance of systemic chemotherapy for extrapancreatic primary tumors is assessed very differently depending of the location. For pancreatic NEN chemotherapy is recommended when progress occurs under biologics therapy. Furthermore, the current situation on data and recommendations with respect to the use of modern molecular targeted therapy is described. In this field two substances are now approved for the treatment of pancreatic neuroendocrine tumors, everolimus and sunitinib. For other primary tumor localizations the benefit of the new molecular targeted substances has not yet been fully clarified. Finally, the possibilities of antiresorptive therapy for bone metastases are briefly described.

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Authors and Affiliations

  1. II. Med. Klinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

    S. Noe & B. Neu

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  1. S. Noe
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  2. B. Neu
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Correspondence to S. Noe.

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S. Noe und B. Neu geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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R. Schmid, München

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Noe, S., Neu, B. Gastroenteropankreatische neuroendokrine Neoplasien (GEP-NEN). Gastroenterologe 10, 418–421 (2015). https://doi.org/10.1007/s11377-015-0013-0

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  • DOI: https://doi.org/10.1007/s11377-015-0013-0

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