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<p>Platinum-based chemotherapy consisting of carboplatin or cisplatin in combination with etoposide is the established standard of care first-line treatment for gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC). For second-line treatment and beyond, chemotherapy protocols, such as FOLFIRI (folinic acid/5-fluorouracil 5‑FU/irinotecan), FOLFOX (folinic acid/5-FU/oxaliplatin) and temozolomide + capecitabine or nanoliposomal pegylated irinotecan (Nal-IRI) +5-FU are available options. Immune checkpoint inhibitors show only limited efficacy as monotherapy. The data situation for combination treatment is very heterogeneous but some GEP-NEC subgroups appear to benefit. In individual cases molecular diagnostics can detect therapeutically relevant alterations, such <i>BRAF</i> mutations, microsatellite instability and neurotrophic tyrosine receptor kinase (NTRK) fusion. Delta-like ligand 3 (DLL3) and seizure-related 6 homolog (SEZ6) are promising new targets for innovative immunotherapy approaches in the form of bispecific antibodies or antibody-drug conjugates.</p>

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Update zur Therapie bei gastroenteropankreatischen neuroendokrinen Karzinomen (GEP-NEC)

  • 期刊论文

  • 发表日期：

    2025年11月6日

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  • Leonidas Apostolidis,
  • Sebastian Krug

摘要

Platinum-based chemotherapy consisting of carboplatin or cisplatin in combination with etoposide is the established standard of care first-line treatment for gastroenteropancreatic neuroendocrine carcinomas (GEP-NEC). For second-line treatment and beyond, chemotherapy protocols, such as FOLFIRI (folinic acid/5-fluorouracil 5‑FU/irinotecan), FOLFOX (folinic acid/5-FU/oxaliplatin) and temozolomide + capecitabine or nanoliposomal pegylated irinotecan (Nal-IRI) +5-FU are available options. Immune checkpoint inhibitors show only limited efficacy as monotherapy. The data situation for combination treatment is very heterogeneous but some GEP-NEC subgroups appear to benefit. In individual cases molecular diagnostics can detect therapeutically relevant alterations, such BRAF mutations, microsatellite instability and neurotrophic tyrosine receptor kinase (NTRK) fusion. Delta-like ligand 3 (DLL3) and seizure-related 6 homolog (SEZ6) are promising new targets for innovative immunotherapy approaches in the form of bispecific antibodies or antibody-drug conjugates.