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Advanced small-bowe...
Advanced small-bowel well-differentiated neuroendocrine tumours : An international survey of practice on 3(rd)-line treatment
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- Lamarca, Angela (författare)
- Univ Manchester, Christie NHS Fdn Trust, European Neuroendocrine Tumor Soc Ctr Excellence, Dept Med Oncol, Wilmslow Rd, Manchester M20 4BX, Lancs, England.
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- Cives, Mauro (författare)
- Univ Bari Aldo Moro, Dept Biomed Sci & Human Oncol, I-70121 Bari, Italy.
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- de Mestier, Louis (författare)
- Univ Paris Diderot, European Neuroendocrine Tumor Soc Ctr Excellence, Dept Gastroenterol & Pancreatol, F-75006 Clichy, France.
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- Crona, Joakim (författare)
- Uppsala universitet,Endokrinkirurgi,Endokrin tumörbiologi,Experimentell kirurgi
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- Spada, Francesca (författare)
- European Inst Oncol, Gastrointestinal Med Oncol & Neuroendocrine Tumor, I-20141 Milan, Italy.
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- Öberg, Kjell, 1946- (författare)
- Uppsala universitet,Science for Life Laboratory, SciLifeLab,Endokrin tumörbiologi
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- Pavel, Marianne (författare)
- Univ Klinikum Erlangen, Dept Endocrinol, D-91054 Erlangen, Germany.
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- Alonso-Gordoa, Teresa (författare)
- Univ Alcala De Henares, Univ Hosp Ramon & Cajal, Ramon & Cajal Hlth Res Inst, Med Oncol Dept, Madrid 28034, Spain.
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Univ Manchester, Christie NHS Fdn Trust, European Neuroendocrine Tumor Soc Ctr Excellence, Dept Med Oncol, Wilmslow Rd, Manchester M20 4BX, Lancs, England Univ Bari Aldo Moro, Dept Biomed Sci & Human Oncol, I-70121 Bari, Italy. (creator_code:org_t)
- BAISHIDENG PUBLISHING GROUP INC, 2021
- 2021
- Engelska.
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Ingår i: World Journal of Gastroenterology. - : BAISHIDENG PUBLISHING GROUP INC. - 1007-9327 .- 2219-2840. ; 27:10, s. 976-989
- Relaterad länk:
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https://doi.org/10.3...
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https://doi.org/10.3...
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
Ämnesord
Stäng
- BACKGROUND Somatostatin analogues are an established first-line therapy for well differentiated small bowel neuroendocrine tumours (Wd-SBNETs), while and peptide receptor radionuclide therapy (PRRT) is frequently used as a second-line therapy. Adequate treatment selection of third-line treatment remains challenging due to the limited prospective data currently available on the best therapeutic sequence. AIM To understand current practice and rationale for decision-making by physicians in the 3(rd)-line setting by building an online survey. METHODS Weighted average (WA) of likelihood of usage between responders (1 very unlikely; 4 very likely) was used to reflect the relevance of factors explored. RESULTS Replies from representatives of 28 centers were received (5/8/2020-21/9/2020); medical oncologist (53.6%), gastroenterologist (17.9%); United Kingdom (21.4%), Spain (17.9%), Italy (14.3%). Majority from European Neuroendocrine Tumor Society (ENETS) Centres of Excellence (57.1%), who followed ENETS guidelines (82.1%). Generally speaking, 3(rd)-line treatment for Wd-SBNETs was: everolimus (EVE) (66.7%), PRRT (18.5%), liver embolization (LE) (7.4%) and interferon-alpha (IFN) (3.7%); chemotherapy (0%); decision was based on clinical trial data (59.3%), or personal experience (22.2%). EVE was most likely used if Ki-67 < 10% (WA 3.27/4) or age < 70 years (WA 3.23/4), in the 3(rd)-line setting (WA 3.23/4); regardless of presence/absence of carcinoid syndrome (CS), rate of progression or extent of disease. Chemotherapy was mainly utilised only if rapid progression (within 6 mo) (WA 3.35/4), Ki-67 10%-20% (WA 2.77/4), negative somatostatin receptor imaging (WA 2.65/4) or high tumour burden (WA 2.77/4); temozolomide or streptozocin was used with capecitabine or 5-fluorouracil (5-FU) (57.7%), FOLFOX (5-FU combined with oxaliplatin) (23.1%). LE was selected if presence of CS (WA 3.24/4) or Ki-67 < 10% (WA 2.8/4), after progression to other treatments (WA 2.8/4). IFN was rarely used (WA 1.3/4). CONCLUSION Everolimus was the most frequently used therapeutic option in the third-line setting. The most important factors for decision-making included Ki-67, rate of progression, functionality and tumour burden; since this decision is based on multiple factors, it highlights the need for a multidisciplinary assessment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Neuroendocrine tumour
- Small bowel
- Survey
- Third-line
- Advanced
- Practice
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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