Clinical management of neuroendocrine neoplasms (NENs)
Casey, Ruth T; Valk, Gerlof D; Schalin-Jäntti, Camilla; Grossman, Ashley B; Thakker, Rajesh V
(2020) European Journal of Endocrinology, volume 183, issue 2, pp. G79 - G88
(Article)
Abstract
In viral pandemics, most specifically Covid-19, many patients with neuroendocrine neoplasms (NENs), including phaeochromocytomas, paragangliomas and medullary thyroid carcinoma, may develop Covid-19 in a mild or severe form, or be concerned about the influence of viral infection relative to their anti-tumoral therapy. In general, newly presenting patients should be assessed,
... read more
and patients recently receiving chemotherapy, targeted therapy or radionuclide therapy, or showing tumour growth, should be closely followed. For previously diagnosed patients, who have indolent disease, some delay in routine follow-up or treatment may not be problematic. However, patients developing acute secretory syndromes due to functional neuroendocrine neoplasms (such as of the pancreas, intestine or lung), phaeochromocytomas and paragangliomas, will require prompt treatment. Patients with life-threatening Covid-19-related symptoms should be urgently treated and long-term anti-tumoral treatments may be temporarily delayed. In patients with especially aggressive NENs, a careful judgement should be made regarding the severity of any Covid-19 illness, tumour grade, and the immunosuppressant effects of any planned chemotherapy, immunotherapy (e.g. interferon-alpha), targeted therapy or related treatment. In other cases, especially patients with completely resected NENs, or who are under surveillance for a genetic disorder, a telephone or delayed consultation may be in order, balancing the risk of a delay against that of the possible development of Covid-19.
show less
Download/Full Text
The full text of this publication is not available.
Keywords: Betacoronavirus, Coronavirus Infections/diagnosis, Disease Management, Endocrinology/methods, Humans, Neoplasm Grading/methods, Neuroendocrine Tumors/diagnosis, Pandemics, Pneumonia, Viral/diagnosis, Telemedicine/methods, Endocrinology, Endocrinology, Diabetes and Metabolism, Journal Article, Review
ISSN: 0804-4643
Publisher: BioScientifica Ltd.
Note: Funding Information: R T C is supported by a grant from GIST Support UK; and R V T is supported by a Wellcome Trust Investigator Award (grant number 106995/Z/15/Z), National Institute for Health Research (NIHR) Oxford Biomedical Research Centre Programme), and NIHR Senior Investigator Award (grant number NF-SI-0514-10091). Funding Information: R T C is supported by a grant from G 阀ST Support UK; and R V T is supported by a Wellcome Trust 阀nvestigator Award (grant number 106995/Z/15/Z), National 阀nstitute for Health Research (N 阀HR) Oxford Biomedical Research Centre Programme), and N 阀HR Senior 阀nvestigator Award (grant number NF-S 阀-0514–10091). Publisher Copyright: © 2020 European Society of Endocrinology.
(Peer reviewed)