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REVISION ACERCA DEL ENFOQUE DE LOS TUMORES NEUROENDOCRINOS BIEN DIFERENCIADOS

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Se presenta una actualización del enfoque diagnóstico y el abordaje terapéutico de las neoplasias neuroendocrinas bien diferenciadas, incluidos los tumores carcinoides y las variantes de localización pancreática, con hincapié en las aplicaciones de las nuevas terapias moleculares dirigidas.
Autor:
Diane Reidy-lagunes
Columnista Experta de SIIC

Institución:
Memorial Sloan-Kettering Cancer Center

Artículos publicados por Diane Reidy-lagunes
Coautor
Ed Wyluda* 
DO, Memorial Sloan-Kettering Cancer Center, Nueva York, EE.UU.*
Recepción del artículo
26 de Abril, 2011 		Aprobación
12 de Julio, 2011
Primera edición
29 de Septiembre, 2011 		Segunda edición, ampliada y corregida
7 de Junio, 2021

REVISION ACERCA DEL ENFOQUE DE LOS TUMORES NEUROENDOCRINOS BIEN DIFERENCIADOS

Resumen
Los tumores neuroendocrinos bien diferenciados (TNE) son neoplasias malignas poco frecuentes que incluyen tanto los carcinoides como los tumores neuroendocrinos pancreáticos (TNEP). Estos tumores se asocian en general con metástasis en el momento del diagnóstico. Si bien la supervivencia prolongada es frecuente, la supervivencia global se reduce de manera acentuada cuando los pacientes presentan síntomas, así como cuando el tumor progresa pese a la terapia con análogos de la somatostatina. Aunque estos fármacos pueden contribuir a tratar la sintomatología y ralentizar el crecimiento tumoral, en especial en neoplasias de bajo grado, no se ha demostrado que el tratamiento a largo plazo sea eficaz en estos pacientes. Recientemente, los ensayos preclínicos y dos estudios de fase III han brindado avances promisorios, sobre todo en el tratamiento de los TNEP. La aparición de terapias dirigidas contra el factor de crecimiento vascular endotelial (VEGF), los inhibidores de la diana de la rapamicina (mTOR) y el tratamiento con receptores de péptidos radiomarcados se ha asociado con eficacia moderada, pero pueden vincularse con toxicidad relevante. En esta revisión, discutiremos los ensayos recientes y las terapias actuales de los TNE bien diferenciados.

Palabras clave
tumores neuroendocrinos bien diferenciados, tumor neuroendocrino pancreático, carcinoide


Artículo completo
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Updates on advanced well-differentiated neuroendocrine tumors

Abstract
Well-differentiated neuroendocrine tumors (NETs) are uncommon malignancies consisting of both carcinoid and pancreatic neuroendocrine tumors (pNETs). These tumors are usually associated with metastasis when diagnosed. Although prolonged survival is common, overall survival decreases substantially when a patient becomes symptomatic and when the tumor progresses on somatostatin analog therapy. While somatostatin analogs can help to treat symptomatology and slow tumor growth mainly in low grade tumors, there have been no proven long term treatments to effectively aid these patients. Recently, two phase III trials along with pre clinical studies have provided promising advancements, mainly in the treatment of pNETs. The emergence of targeted therapies consisting of vascular endothelial growth factor (VEGF), mammalian target of rapamycin (mTOR) inhibitors and peptide receptor radiolabeled therapy (PRRT) have demonstrated modest efficacy but can result in non-trivial toxicities. In this review we will discuss recent trials and current therapies for well-differentiated NETs.

Key words
well-differentiated neuroendocrine tumors, pancreatic neuroendocrine tumor, carcinoid


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Especialidades
Principal: Oncología
Relacionadas: Anatomía Patológica, Diagnóstico por Imágenes, Diagnóstico por Laboratorio, Endocrinología y Metabolismo, Farmacología, Gastroenterología, Geriatría, Medicina Farmacéutica, Medicina Interna, Medicina Nuclear



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Enviar correspondencia a:
Diane Reidy-Lagunes, Memorial Sloan-Kettering Cancer Center, NY 10065, 275 York Avenue, Room H-917, Nueva York, EE.UU.
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