Neuroendocrine Neoplasia Management. New Approaches for Diagnosis and Treatment PDF
Preview Neuroendocrine Neoplasia Management. New Approaches for Diagnosis and Treatment
Neuroendocrine Neoplasia Management New Approaches for Diagnosis and Treatment Giordano Beretta Alfredo Berruti Emilio Bombardieri Nicola Fazio Orlando Goletti Editors 123 Neuroendocrine Neoplasia Management Giordano Beretta • Alfredo Berruti Emilio Bombardieri Nicola Fazio • Orlando Goletti Editors Neuroendocrine Neoplasia Management New Approaches for Diagnosis and Treatment Editors Giordano Beretta Alfredo Berruti Oncology Unit ASST-Spedali Civili Humanitas Gavazzeni University of Brescia Bergamo, Italy BRESCIA Brescia, Italy Emilio Bombardieri Nuclear Medicine Nicola Fazio Humanitas Gavazzeni GIT Med Oncology & Neuroendocrine BERGAMO Tumors Bergamo, Italy European Institute of Oncology Milan, Italy Orlando Goletti General Surgery Unit Humanitas Gavazzeni Bergamo, Italy ISBN 978-3-030-72829-8 ISBN 978-3-030-72830-4 (eBook) https://doi.org/10.1007/978-3-030-72830-4 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Italo Nosari, MD, born on June, 14, 1950, and passed away on March, 4, 2020. This book on Neuroendocrine Neoplasia is dedicated to our friend and colleague Italo Nosari, endocrinologist, who brought a great personal contribution to the discipline and in particular to diabetology. He has held relevant roles inside the Association of Physicians Diabetologists (AMD) and the Italian Society of Diabetology (SID). He produced a lot of scientific papers published in international literature. He has always practiced his intense clinical activity over years with great passion, full dedication, and love for his patients, both pediatric and adults. He was a very active member of our Multidisciplinary Groups of Humanitas Gavazzeni showing in all circumstances availability, competence, and humanity. During the outbreak of COVID-19 in Bergamo, he generously offered his precious assistance in the Emergency Department of the Hospital without sparing himself. Unfortunately the viral infection took him away, while he was doing his mission, leaving everyone with an indelible memory. Foreword The book Neuroendocrine Neoplasia Management, edited by G. Beretta, A. Berruti, E. Bombardieri, N. Fazio, and O. Goletti, is a timely and compre- hensive compilation of recent developments within the field of neuroendo- crine tumors (NENs.) Current book publications in endocrinology, oncology, surgery, and gas- troenterology offer specific chapters on neuroendocrine tumors but only in a superficial manner. This book covers all the aspects of neuroendocrine tumor management including epidemiology, diagnosis, and treatment of various subtypes of NENs. It will serve both as an excellent textbook for younger colleagues, medical students, and new beginners in the NEN field and as a refresher for more experienced colleagues. NENs is a complicated field that needs collaboration among many specialists, endocrinologists, oncologists, surgeons, radiolo- gists, and gastroenterologists; therefore, this book will be an excellent guide in the management of NENs. Neuroendocrine tumors is a rather young entity within the oncology field formulated by Italian and Scandinavian pathologists in the early 1970s, who also coined the term “Neuroendocrine Tumor” because of the characteristic picture of both neural and endocrine elements. The area started to mature with the development of specific radioimmunoassays for substances (bio- markers) secreted by the tumors. The diagnostic and therapeutic tools were rather sparse in the beginning, but during the 1980s and 1990s, the field started to grow exponentially thanks to new diagnostics and therapeutics (CgA, Ki-67, somatostatin scintigraphy, somatostatin analogs, IFNs, new chemotherapies). The refined diagnostics showed differences in tumor biology and genetics, and new imaging procedures (PET/CT; PET/MR) gave improved staging pro- cedures and a new classification system (WHO). This clearly demonstrated that the therapy had to be further developed, “one size did not fit all.” Custom- made therapies have been developed including biotherapy, specific chemo- therapies, targeted agents, and finally peptide receptor radio therapy (PRRT). Surgery has been more developed with tissue sparing procedures. Instrumental works by Italian pathologists have given us insights into molecular genetics and oncology development which will in the future refine the management of NENs. vii viii Foreword Looking at the authors list of this book, a number of them have made sig- nificant contributions to the NEN field, which further enhances the impor- tance of this publication covering an earlier unmet need of summarizing the most recent development in the NEN area. This book should be in the book- shelf of every colleague working with NEN patients. Kjell Öberg Department of Medical Sciences Uppsala University Uppsala, Sweden Department of Endocrine Oncology University Hospital Uppsala, Sweden Preface Several books have been published on the subject “neuroendocrine tumors” in these years, because this topic is of great clinical importance in oncology and endocrinology. The reasons are to be found in their very interesting biol- ogy, the relevant epidemiology, the evolution in the diagnostic technologies, and the recent development of novel emerging and successful therapies that stimulated a lot of clinical trials. The agents targeting angiogenesis and/or PI3K/AKT/mTOR pathway, alone or in combination with analogues, have provided encouraging results in advanced disease. In this book an original approach has been adopted, with the aim to pro- vide a general update in prognosis, diagnosis, and therapy by covering the whole family of neuroendocrine tumors. As the title “Neuroendocrine Neoplasia (NEN)” suggests, all tumors from various organs and/or particular histology, MEN-related tumors, MiNEN, NEC, and Merkel’s tumors have been included. The structure of the book consists in a general part and in a part with spe- cific chapters. The general part of the book is focused on the history, the epidemiology, and the most important results and the fast developments in scientific and clinical knowledge in the field of diagnosis and therapy. In particular the authors discuss the advances in genetic analysis and molecular biology, the endoscopic techniques combined with guided biopsy, the high-resolution imaging associated with endoscopy, the metabolic imag- ing from radioreceptor targeting, and the hybrid PET/CT and MRI instrumen- tation alone or in combination. In the area of therapy, particular attention is paid to the emerging strategies of treatment, the surgery and minimally invasive surgery for both early stage and advanced diseases, and the loco-regional and systemic treatments includ- ing targeted therapy and/or biological therapies. The second part of the book depicts the clinical management of the differ- ent groups of NEN from different anatomical origin and/or with particular histology and discusses some novel approaches of diagnosis and therapy, the spectrum of the current available options, and the most important results from the most successful clinical trials. The structure and the content of this book follow the philosophy of the concept that is gaining increasing importance, i.e., that, among the big family of tumors taking origin from neuroendocrine cells, the traditional paradigm classifying neuroendocrine tumors as a single entity is no longer sufficient to ix x Preface explain the differences often observed in the prognosis and tumor responsiv- ity of the various groups of patients with “different neuroendocrine neoplasias.” The most distinguished experts in the field have been invited to contribute to this book. All authors worked together with great enthusiasm by integrat- ing their different skills in a multidisciplinary collaboration, with the contri- bution of oncologists, endocrinologists, pathologists, nuclear physicians, surgeons, physicists, radio-pharmacists, gastroenterologists, and biologists. Thanks to their interactive work, they set up this informative publication that provides valuable insights for all professionals interested in the modern man- agement of neuroendocrine neoplasias. Bergamo, Italy Giordano Beretta Brescia, Italy Alfredo Berruti Bergamo, Italy Emilio Bombardieri Milan, Italy Nicola Fazio Bergamo, Italy Orlando Goletti Acknowledgments The editors are grateful to Ms. Anna Luisa De Simone Sorrentino, Fondazione IRCCS Istituto Nazionale Tumori (Milano), for her valid collaboration in connecting authors and for her secretarial help. xi
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