Priorities for Improving the Management of Gastroenteropancreatic Neuroendocrine Tumors

• Published in: JNCI : Journal of the National Cancer Institute Vol. 100; no. 18; pp. 1282 - 1289
• Main Authors: Modlin, Irvin M., Moss, Steven F., Chung, Daniel C., Jensen, Robert T., Snyderwine, Elizabeth
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 17.09.2008; Oxford Publishing Limited (England)
• Subjects: Animals; Biomarkers, Tumor - analysis; Biomarkers, Tumor - blood; Biomedical Research - standards; Biomedical Research - trends; Carcinoid Tumor - complications; Carcinoid Tumor - diagnosis; Carcinoid Tumor - epidemiology; Carcinoid Tumor - metabolism; Carcinoid Tumor - therapy; Disease Models, Animal; Early Diagnosis; Endocrinology; Gastroenterology; Gastrointestinal Neoplasms - complications; Gastrointestinal Neoplasms - diagnosis; Gastrointestinal Neoplasms - epidemiology; Gastrointestinal Neoplasms - metabolism; Gastrointestinal Neoplasms - therapy; Humans; Incidence; Interdisciplinary Communication; Medical treatment; National Cancer Institute (U.S.); Neoplasm Staging; Neuroendocrine Tumors - complications; Neuroendocrine Tumors - diagnosis; Neuroendocrine Tumors - epidemiology; Neuroendocrine Tumors - metabolism; Neuroendocrine Tumors - therapy; Pancreatic cancer; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - epidemiology; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - therapy; Prevalence; Prognosis; Research Support as Topic; Risk Factors; SEER Program; Survival Rate; United States - epidemiology
• ISSN: 0027-8874; 1460-2105; 1460-2105
• DOI: 10.1093/jnci/djn275

A National Cancer Institute summit meeting on gastroenteropancreatic neuroendocrine and carcinoid tumors was held in September 2007 to present the currently accepted standards of care for patients with these tumors and to identify areas requiring investigation and development. These tumors are clinically and pathologically heterogeneous, present commonly with obscure symptoms that lead to delays in diagnosis of years, and have an incidence in the United States of 2.5 to 5 cases per 100 000. The 5-year survival rates range between 15% and 95%, depending on the site and extent of disease. This report delineates the main conclusions of the meeting, including the best practice diagnosis and treatment strategies for gastropancreatic neuroendocrine tumors, and the identification of clinical and scientific areas that are most in need of attention. The most pressing needs were public and physician education, identification of molecular markers for early diagnosis and therapeutic monitoring, improved imaging modalities and molecular prognostication, development of a standardized pathological classification system, and creation of regional centers of expertise with tumor and laboratory data banks. In addition, adequately validated neuroendocrine tumor models and cell lines should be established to investigate the molecular mechanisms involved in the control of their growth and secretion, and to facilitate the development of specific therapies that should be examined in well-designed multicenter studies of defined patient groups.