Expertendialog: Neuroendokrine Tumore der Lunge und des gastroenteropankreatischen Systems

Zusammenfassung

Hintergrund: Neuroendokrine Tumore der Lunge weisen eine deutlich ansteigende Inzidenz auf. Über Diagnose und Therapie dieser Tumoren existieren jedoch nur wenig gesicherte Informationen. Demgegenüber liegen deutlich mehr Daten für die neuroendokrinen Tumore des gastroenteropankreatischen Systems vor.

Methode: Dialog mit Fachexperten für neuroendokrine Tumore (NET) des gastroenteropankreatischen Systems und der Lunge am 25. und 26. Februar 2011 in Weimar, um Gemeinsamkeiten und Unterschiede zwischen den neuroendokrinen Tumoren der Lunge und des gastroenteropankreatischen Systems herauszustellen.

Ergebnisse: Die neuroendokrinen Tumoren der Lunge weisen viele Gemeinsamkeiten, aber auch einige Unterschiede mit den gastroenteropankreatischen NETgastroenteropankreatischen Tumoren auf. Gemeinsamkeiten bestehen vor allem in der Pathologie, der Diagnosestellung und der Therapie. Unterschiede bestehen in den Empfehlungen zur systemischen Therapie und der deutlich geringeren Inzidenz paraneoplastischer Syndrome. Das Somatostatinrezeptor-PET/CT mit Gallium-68 konjugierten Somatostatinanaloga und die Peptid-Rezeptor vermittelte Radiorezeptortherapie sind innovative Verfahren für die neuroendokrinen Tumore der Lunge. An erster Stelle der Therapie steht jedoch die komplette kurative Resektion. Erste Ergebnisse von Studien mit molekularen Wirkstoffen wie Everolimus (Afinitor^®) zeigen eine Wirksamkeit an.

Schlussfolgerungen: Es existieren deutliche Schnittmengen in der Diagnose und Therapie der neuroendokrinen Tumore der Lunge und des gastroenteropankreatischen Systems. Weitere Studien sind geplant und notwendig, um die Datenlage zu verbessern. Ein Register zur Erfassung der neuroendokrinen Tumore der Lunge wäre sinnvoll.

Abstract

Background: Neuroendocrine tumours of the lung exhibit an increasing incidence and prevalence. However, data on the diagnosis of and therapy for these tumours are sparse compared to neuroendocrine tumours of the gastroenteropancreatic system.

Methods: The present article reflects a dialogue between experts on neuroendocrine tumors of the lung and the gastroenteropancreatic system held on February 25th and 26th in Weimar, Germany.

Results: Many similarities exist between neuroendocrine tumours of the lung and the gastroenteropancreatic system but there are also significant differences. Similarities exist mainly concerning pathology, diagnosis and therapy. Differences exist regarding the systemic therapy and the significantly lower incidence of paraneoplastic syndromes. Somatostatin receptor PET/CT with gallium-68 labelled somatostatin analogues and peptide receptor radiotherapy are innovative methods for the diagnosis of and therapy for neuroendocrine tumours of the lung. The first treatment option remains complete resection of the tumour. Small molecules like everolimus (Afinitor^®) have been tested in clinical trials and have been shown to prolong progression-free survival.

Conclusions: Additional studies are necessary and efforts should be undertaken to establish a registry to increase data on methods suitable for he diagnosis of and therapy for neuroendocrine tumours of the lung.

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