![]() These antibodies, named ‘immune checkpoint inhibitors’ (ICIs), have opened a new era in oncology. ![]() The Cytotoxic T-Lymphocyte Antigen 4 (CTLA-4) and the programmed death-1 (PD-1) and programmed death-1 ligand (PD-L1) represent a key point regarding escape from immune surveillance by cancer cells, and this reason has led to the development of antibodies against these molecules. Immune evasion mechanisms have a pivotal role for tumor cell proliferation and growth. Target therapy, understood as use of drugs or other substances that targets specific molecules to arrest the growth and spread of cancer cells, has sharply revolutionized the outcomes of different types of cancer.Ĭurrently, another intriguing weapon available in cancer therapy is represented by immunotherapy, based on the stimulation of the immune system against cancer cells through the introduction of cytokines and antibodies (passive immunotherapy) or the introduction of vaccines and immune cells themselves (active immunotherapy). While in the past the field of cancer therapy was dominate by surgery and radiotherapy associated with chemotherapy, in the last decades research has provided new treatment strategies, such as target therapies. Equally essential will be the identification of biomarkers useful for selecting patients potentially responsive to this type of treatment. A radiation treatment that increases tumor-infiltrating lymphocytes, could be another approach to explore before ICIs in NENs. ![]() A sequential chemotherapy, possibly inducing an increase in tumor mutational burden and tested before immunotherapy, could be a hypothesis deserving more consideration. Therefore, the combination of conventional therapy, target therapy and immunotherapy deserve attention and warrant to be explored. Such numbers highlight the growing attention gathering around NENs and ICIs, in response to the need of stronger evidences supporting such therapy.įor the future, the most important aspect will be to study strategies that can make NETs more susceptible to response to ICI and, thus, enhance the effectiveness of these treatments. However, the near future, might reserve interesting results for ICIs in GEP-NEN from a total of nine different ICI drugs, used throughout 19 randomised controlled trials. In fact, with regard to the well-differentiated forms of NENs (NETs), the results obtained nowadays have been disappointing. In this article, we provide an overview on the current knowledge about immunotherapy with immune checkpoint inhibitors (ICIs) applied to NENs, evaluating future perspectives in this setting of tumors.Įvidence so far available for ICIs in gastroenteropancreatic (GEP)-NENs is definitively not as robust as for other tumors such as Small Cell Lung Cancer or Merkel Cell Carcinoma. Immunotherapy, so promising in many neoplasms, still does not have a precise role in the treatment of neuroendocrine neoplasms (NENs).
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