Cytoreductive chemotherapy is the therapy of choice for advanced, poorly differentiated and undifferentiated neuroendocrine neoplasms (carcinomas). Cytoreductive chemotherapy such as etoposide and cisplatin improves the quality of life and prolongs survival in patients with undifferentiated neuroendocrine carcinoma. In contrast, cytoreductive chemotherapy does not prolong survival or improve quality of life of patients suffering from well-differentiated (G1) carcinoids.

Advanced neuroendocrine tumors of the pancreas play an intermediate role: Cytoreductive chemotherapy should be considered for G2-differentiated neuroendocrine tumors of the pancreas (Ki-67 expression between 2% and 20%), if first-line targeted therapy has failed. In recent years temozolomide has been established as an effective cytostatic drug in addition to the traditional combinations of 5-FU/streptozocin and doxorubicin/streptozocin. In the future individual and personalized medical treatment may be provided on the basis of the molecular properties of the individual tumor ("molecular tumor profile").

Interferon-alpha is also used to treat well-differentiated islet cell tumors of the pancreas. Interferon-alpha stimulates the patient's immune system so that a stronger defense against the tumor tissue can be built up.

Prof. Dr. med. Hans Scherübl


Center of Neuroendocrine Tumors
Prof. Dr. med. Hans Scherübl
Vivantes Klinikum Am Urban
Academic Teaching Hospital of Charité-University Medicine, Berlin
Dieffenbachstraße 1
10967 Berlin, Germany
Tel: + 49 30 130 225201
Fax: + 49 30 130 225205
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