Still difficult to diagnose and very heterogeneous from a clinical and biological point of view, neuroendocrine tumors are a group of neoplasms that register more than 2,600 new cases in Italy every year. Faced with this complexity, the response must be multidisciplinary and the discussion of the best therapy must be taken on a case-by-case basis. This is the conclusion reached by a recent review conducted by the Italian Association of Medical Oncology (AIOM) carried out thanks to the unconditional support of Ipsen SpA and published in the journal Cancer Treatment Reviews.
“We conducted an analysis to evaluate the effective role of octreotide and lanreotide drugs - underlines Saverio Cinieri, National President of AIOM -. These are two somatostatin analogues that we have been using for years as therapies capable of blocking tumor growth and controlling some symptoms associated with the disease. However, their use in some clinical settings for gastroenteropancreatic and lung neuroendocrine tumors is controversial. There is no universal agreement among specialists as the scientific evidence is not so clear cut. Even the various international guidelines are sometimes discrepant with each other".
Cases to be discussed in groups
The publication evaluated eight unique clinical situations in which the use of somatostatin analogues is debated. "It emerged that, unlike classic clinical situations where the use of these therapies is routine, there are particular contexts in which octreotide and lanreotide can determine benefits for selected patients, although the scientific evidence is modest", underlined Nicola Fazio, Director of the Digestive System Tumors and Neuroendocrine Program of the European Institute of Oncology IEO. "This type of case should be discussed within multidisciplinary groups dedicated to neuroendocrine tumors, including clinicians such as oncologist, endocrinologist, gastroenterologist, internist, nuclear doctor."
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Neuro-endocrine tumors affect a total of 24,000 patients in Italy and five-year survival stands at 63%. Neuroendocrine neoplasms, whose incidence is progressively growing, are forms of cancer that originate from cells of the neuroendocrine system and which can develop in various organs. “Gastroenteropancreatic and pulmonary ones, which we took into consideration in the review, represent over 80% of all cases. As they are infrequent, they are oncological diseases that are more difficult to diagnose and treat and, therefore, patients should be managed in reference centres”, explains Fazio.
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The specialized centres
In Italy there are eight centers of excellence for the treatment of gastroenteropancreatic neuroendocrine tumors that have received certification from the European Society of Neuroendocrine Tumors. “There are also various hospital, university or research structures, in which there are mono or oligo-specialist skills for the treatment of these particular forms of cancer. They are complex neoplasms and against which important results have been obtained in the last 20 years. Greater coordination on the scientific research front is essential if we want to further increase survival rates”, concludes Cinieri.