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Medical management of secretory syndromes related to gastroenteropancreatic neuroendocrine tumours

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Dimitriadis, Georgios K., Weickert, Martin O., Randeva, Harpal S., Kaltsas, Gregory and Grossman, Ashley (2016) Medical management of secretory syndromes related to gastroenteropancreatic neuroendocrine tumours. Endocrine-Related Cancer, 23 (9). R423-R436. doi:10.1530/ERC-16-0200

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Official URL: http://dx.doi.org/10.1530/ERC-16-0200

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Abstract

Although recent epidemiological evidence indicates that the prevalence of non-functioning gastroenteropancreatic (GEP) neuroendocrine tumours (NETs) is rising, a significant number of GEP-NETs still present with symptoms related to the secretion of biologically active substances leading to the development of distinct clinical syndromes. In the past, these syndromes were associated with substantial morbidity and mortality due to the lack of specific therapies; however, since the introduction of long-acting somatostatin analogues and medications such as proton pump inhibitors, their control has been greatly improved. As a result, nowadays, the main cause of morbidity and mortality in GEP-NETs is mostly directly related to tumour growth and the extent of metastatic disease. However, in some patients with functioning tumours and extensive disease, control of the secretory syndrome still remains problematic, necessitating the employment of several cytoreductive techniques, which may not always be sufficient. Recently, new agents directed against tumour growth, or exerting increased binding activity to receptors expressed in these tumours, or interfering with the synthetic pathway of some of the compounds secreted by these tumours, have been developed. Since there are no specific guidelines addressing the totality of the management of the secretory syndromes related to GEP-NETs, this review aims at critically analysing the medical management of previously recognised secretory syndromes; it also addresses areas of uncertainty, assesses the newer therapeutic developments and also addresses recently described but poorly characterised secretory syndromes related to GEP-NETs.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Neuroendocrine tumors, Somatostatin, Proton pump inhibitors, Metastasis
Journal or Publication Title: Endocrine-Related Cancer
Publisher: BioScientifica
ISSN: 1351-0088
Official Date: 26 July 2016
Dates:
DateEvent
26 July 2016Published
26 July 2016Accepted
Volume: 23
Number: 9
Page Range: R423-R436
DOI: 10.1530/ERC-16-0200
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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