Current Status of Immunotherapy in Management of Small Bowel Neuroendocrine Tumors

Curr Oncol Rep. 2024 Nov;26(11):1530-1542. doi: 10.1007/s11912-024-01610-w. Epub 2024 Oct 28.

Abstract

Purpose of review: This study aims to present the current landscape of immunotherapy in the management of small bowel neuroendocrine tumors and identify ongoing and future targets for improved response.

Recent findings: Somatostatin analogs and mTOR inhibitors remain cornerstones of non-surgical treatment, and applications of PRRT in SBNET are promising. Several efforts to replicate the success of immunotherapies in other solid tumors have been attempted in SBNET, with limited responses observed with current immune targets, such as PD-1/PD-L1 and CTLA-4. Epigenetic analyses have suggested a potential role for methylation and histone acetylation in SBNET tumorigenesis that warrant greater exploration. While the incidence of SBNET continues to increase, the number of effective therapies is few. Further elucidation of targetable components of the SBNET immune microenvironment with greater modulatory effects is necessary to improve outcomes in this growing patient population.

Keywords: Clinical trials; Immunotherapy; Neuroendocrine tumors; Overall survival; Progression-free survival.

Publication types

  • Review

MeSH terms

  • Humans
  • Immune Checkpoint Inhibitors / therapeutic use
  • Immunotherapy* / methods
  • Intestinal Neoplasms* / immunology
  • Intestinal Neoplasms* / pathology
  • Intestinal Neoplasms* / therapy
  • Intestine, Small / immunology
  • Neuroendocrine Tumors* / immunology
  • Neuroendocrine Tumors* / therapy
  • Tumor Microenvironment / immunology

Substances

  • Immune Checkpoint Inhibitors