Comparative safety review of the current therapies for gastroenteropancreatic neuroendocrine tumors

Introduction: Neuroendocrine neoplasms (NENs) comprise a heterogeneous group of neoplasms, whose management requires complex and individualized clinical decisions. Over the last decades the advent of novel medications and advanced diagnostic and therapeutic modalities, alongside our deeper understanding of the disease, revolutionized the landscape of their management, significantly improving both prognosis and quality of life of patients. Area covered: Treatment-related adverse events and safety concerns as demonstrated in clinical trials, as well as in real-world clinical practice. Expert opinion: The only true curative option for NENs remains surgery, whereas high-grade advanced neuroendocrine carcinomas should be primarily managed with platinum-based chemotherapy. For the remaining cases, that comprise the vast majority, the current armamentarium includes somatostatin analogs, interferon, telotristat ethyl, molecular targeted therapies, chemotherapy, peptide receptor radionuclide therapy, and locoregional treatment. The use of the aforementioned therapeutic options is associated with several and not uncommonly severe treatment-related adverse events. However, the benefits offered inclusive of improved prognosis, amelioration of symptoms, and better quality of life amidst others, by far outweighs any adverse event.

Automated summary

Neuroendocrine neoplasms (NENs) are a heterogeneous group of neoplasms that require complex and individualized clinical decisions for management. Surgery is the only curative option, while high-grade advanced carcinomas should be primarily managed with platinum-based chemotherapy. Other treatment options include somatostatin analogs, interferon, targeted therapies, chemotherapy, peptide receptor radionuclide therapy, and locoregional treatment, all of which have associated treatment-related adverse events. However, the benefits offered by these treatments far outweigh the risks, leading to improved prognosis, symptom management, and quality of life for patients.