Precision medicine in gastroenteropancreatic neuroendocrine neoplasms: Where are we in 2023?

IF 6.1 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Best practice & research. Clinical endocrinology & metabolism Pub Date : 2023-09-01 DOI:10.1016/j.beem.2023.101794

Nicola Fazio (Oncologist, Director of Program in Digestive System and Neuroendocrine Tumors) , Anna La Salvia (Oncologist, Researcher)

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引用次数: 0

Abstract

Precision medicine describes a target-related approach to tailoring diagnosis and treatment of the individual patient. While this personalized approach is revoluzionizing many areas of oncology, it is quite late in the field of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs), in which there are few molecular alterations to be therapeutically targeted. We critically reviewed the current evidence about precision medicine in GEP NENs, focusing on potential clinically relevant actionable targets for GEP NENs, such as the mTOR pathway, MGMT, hypoxia markers, RET, DLL-3, and some general agnostic targets. We analysed the main investigational approaches with solid and liquid biopsies. Furthermore, we reviewed a model of precision medicine more specific for NENs that is the theragnostic use of radionuclides. Overall, currently no true predictive factors for therapy have been validated so far in GEP NENs, and the personalized approach is based more on clinical thinking within a NEN-dedicated multidisciplinary team. However, there is a robust background to suppose that precision medicine, with the theragnostic model will yield new insights in this context soon.

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胃肠胰神经内分泌肿瘤的精准医疗:2023年我们在哪里?

精准医学描述了一种与目标相关的方法来定制个体患者的诊断和治疗。虽然这种个性化的方法正在改变肿瘤学的许多领域，但在胃肠胰神经内分泌肿瘤（GEP-NENs）领域已经相当晚了，在该领域几乎没有可作为治疗靶点的分子改变。我们批判性地回顾了目前关于GEP-NEN精准医学的证据，重点关注GEP-NENs潜在的临床相关可操作靶点，如mTOR途径、MGMT、缺氧标志物、RET、DLL-3和一些一般不可知靶点。我们分析了固体和液体活检的主要研究方法。此外，我们还回顾了一种更专门针对NEN的精确医学模型，即放射性核素的诊断用途。总体而言，到目前为止，GEP NEN还没有验证治疗的真正预测因素，个性化方法更多地基于NEN专门的多学科团队的临床思维。然而，有一个强有力的背景可以假设，精准医学和灵药模型将很快在这方面产生新的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best practice & research. Clinical endocrinology & metabolism 医学-内分泌学与代谢

CiteScore

11.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management. Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.