Comparative safety review of the current therapies for gastroenteropancreatic neuroendocrine tumors

Expert Opin Drug Saf. 2021 Mar;20(3):321-334. doi: 10.1080/14740338.2021.1867097. Epub 2020 Dec 27.


Introduction: Neuroendocrine neoplasms (NENs) comprise a heterogeneous group of neoplasms, whose management requires complex and individualized clinical decisions. Over the last decades the advent of novel medications and advanced diagnostic and therapeutic modalities, alongside our deeper understanding of the disease, revolutionized the landscape of their management, significantly improving both prognosis and quality of life of patients.Area covered: Treatment-related adverse events and safety concerns as demonstrated in clinical trials, as well as in real-world clinical practice.Expert opinion: The only true curative option for NENs remains surgery, whereas high-grade advanced neuroendocrine carcinomas should be primarily managed with platinum-based chemotherapy. For the remaining cases, that comprise the vast majority, the current armamentarium includes somatostatin analogs, interferon, telotristat ethyl, molecular targeted therapies, chemotherapy, peptide receptor radionuclide therapy, and locoregional treatment. The use of the aforementioned therapeutic options is associated with several and not uncommonly severe treatment-related adverse events. However, the benefits offered inclusive of improved prognosis, amelioration of symptoms, and better quality of life amidst others, by far outweighs any adverse event.

Keywords: Neuroendocrine neoplasms; everolimus; peptide receptor radionuclide therapy; somatostatin analogs; sunitinib; telotristat ehtyl; temozolomide/capecitabine.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Antineoplastic Agents* / administration & dosage
  • Antineoplastic Agents* / adverse effects
  • Humans
  • Intestinal Neoplasms / pathology
  • Intestinal Neoplasms / therapy*
  • Molecular Targeted Therapy*
  • Neuroendocrine Tumors / pathology
  • Neuroendocrine Tumors / therapy*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / therapy*
  • Prognosis
  • Quality of Life
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / therapy*


  • Antineoplastic Agents

Supplementary concepts

  • Gastro-enteropancreatic neuroendocrine tumor