Minireviews
Copyright ©The Author(s) 2022.
World J Gastroenterol. Mar 21, 2022; 28(11): 1123-1138
Published online Mar 21, 2022. doi: 10.3748/wjg.v28.i11.1123
Table 1 Current evidence about available prognostic factors for either metastatic spread or tumor progression/recurrence in rectal neuroendocrine neoplasms
Prognostic factor
Cut-off
Risk of metastases
Evidence
Tumor size15 mm14%Retrospective large study[27]
Grading G250%Retrospective study[30]
G333%Retrospective study[30]
Lymph node statusN2 (≥ 5 positive lymph nodes)Not quantifiedRetrospective study[35]
Depth of invasion Invasion of the muscolaris propriaNot quantifiedRetrospective study[37]
Table 2 Systemic therapies for advanced disease
Pharmacological class
Therapeutic agent
Superiority vs placebo
Main ongoing clinical trials
Somatostatin analogsOctreotide (30 mg/4 wk i.m.)Yes[70]NCT04129255
Lanreotide (120 mg/4 wk s.c.)Yes[69]NCT03289741 (octreotide vs lanreotide)
CytokinesInterferon-α (3 MIU/three times a week s.c.)Yes[72]NCT02838342 (association with cyclophosfamide)
Targeted agents Everolimus (10 mg/d p.o.)Yes[73]NCT02248012 (association with temozolomide)
Sunitinib (50 mg/d p.o.)Yes[74]1NCT00056693NCT02315625
Cabozantinib (40-60 mg/d p.o.)NANCT05048901
Sorafenib (800 mg/d p.o.)NANCT00605566, NCT00131911
Radioligand therapy177Lu-DOTATATE (Lutathera)Yes[76]NCT02743741, NCT03972488 (combination with LAR)
ChemotherapyCisplatin/carboplatin ± etoposide/irinotecan Yes[79]NCT03963193 (etoposide + cisplatin vs irinotecan + cisplatin)
Streptozocin ± 5-FU ± doxorubicin Yes[80]NCT00602082
5-FU ± dacarbazine ± epirubicinYes [81]NA