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Advanced small-bowe...
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Lamarca, AngelaUniv Manchester, Christie NHS Fdn Trust, European Neuroendocrine Tumor Soc Ctr Excellence, Dept Med Oncol, Wilmslow Rd, Manchester M20 4BX, Lancs, England.
(författare)
Advanced small-bowel well-differentiated neuroendocrine tumours : An international survey of practice on 3(rd)-line treatment
- Artikel/kapitelEngelska2021
Förlag, utgivningsår, omfång ...
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BAISHIDENG PUBLISHING GROUP INC,2021
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-440427
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-440427URI
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https://doi.org/10.3748/wjg.v27.i10.976DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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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 och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Cives, MauroUniv Bari Aldo Moro, Dept Biomed Sci & Human Oncol, I-70121 Bari, Italy.
(författare)
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de Mestier, LouisUniv Paris Diderot, European Neuroendocrine Tumor Soc Ctr Excellence, Dept Gastroenterol & Pancreatol, F-75006 Clichy, France.
(författare)
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Crona, JoakimUppsala universitet,Endokrinkirurgi,Endokrin tumörbiologi,Experimentell kirurgi(Swepub:uu)joacr310
(författare)
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Spada, FrancescaEuropean Inst Oncol, Gastrointestinal Med Oncol & Neuroendocrine Tumor, I-20141 Milan, Italy.
(författare)
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Öberg, Kjell,1946-Uppsala universitet,Science for Life Laboratory, SciLifeLab,Endokrin tumörbiologi(Swepub:uu)kjellob
(författare)
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Pavel, MarianneUniv Klinikum Erlangen, Dept Endocrinol, D-91054 Erlangen, Germany.
(författare)
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Alonso-Gordoa, TeresaUniv Alcala De Henares, Univ Hosp Ramon & Cajal, Ramon & Cajal Hlth Res Inst, Med Oncol Dept, Madrid 28034, Spain.
(författare)
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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)
Sammanhörande titlar
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Ingår i:World Journal of Gastroenterology: BAISHIDENG PUBLISHING GROUP INC27:10, s. 976-9891007-93272219-2840
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