Neuroendocrine neoplasms
Neuroendocrine neoplasms (NEN) are characterized by the production of so-called neuroendocrine proteins/markers, synaptophysin and chromogranin A, whose presence in tumor tissues is determined by fine tissue examination.
NENs are divided into neuroendocrine tumors(NETs) and neuroendocrine carcinomas(NECs). Hormone-producing (endocrine) cells are found in most organs and are considered the initial cells of at least NET but not necessarily NEC. In NET, tumor cells still show a similar structure to their previously healthy parent cells and usually grow slowly. In NEC, on the other hand, the tumor cells usually no longer show similarities to their respective parent organ and grow rapidly and aggressively.
NEN are most commonly found in the gastrointestinal tract and lungs. They are rare overall, but their incidence is increasing: the annual incidence rate is currently more than 5 per 100,000 inhabitants per year.
The therapy of NET tumors has several goals
NET treatment
For symptom control and growth (proliferation) inhibition, biotherapy with so-called somatostatin analogues is primarily used, which curbs excessive signals for tumor cell growth. Furthermore, surgery, endoscopy, tumor-destroying procedures of metastases in the liver (SIRT, TACE), radiotherapy (peptide receptor-based radio therapy (PRRT)), targeted molecular therapies (MT), and chemotherapies (CTx) represent additional therapeutic modalities.
Based on these options, an individualized and thus personalized tumor therapy is tailored for each NET patient. However, after a shorter or longer duration, inefficacies (resistances) can develop for the therapies used. This can lead to treatment failure, which then threatens and limits quality of life and lifespan in a significant way. Accordingly, there is a great need for research to develop ever better and equally well-tolerated novel therapeutic approaches precisely for such situations.
NEC treatment
For the treatment of patients with NEC, chemotherapeutic agents are used first and foremost. Other procedures, such as surgical treatment, radiotherapy, PRRT and targeted molecular therapies (MT) can rarely be used in NEC patients due to the aggressive biology of these tumors.
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