Extreme long survival under combined immunotherapy in a case of metastatic functional NEN-patient
Schmidt D. · Wiedenmann B
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Treatment and prognosis of neuroendocrine neoplasia (NEN) depends on tumor size, stage, grade, resectability and extent of distant metastasis.
In most cases a multimodality approach incl. surgical, locally invasive procedures, peptide guided radio receptor therapy (PRRT) and medical therapies represents the mainstay of treatment in advanced disease.
In the reported case, a 68-year old man was diagnosed in 2010 with an initially functional neuroendocrine tumor of gastric type III, G2, stage IVB, cT4cN1cM1 (hep., per., nod., oss.), incl. hepatic tumor load of 25%.
Intensive multimodality approaches including combined immunotherapy (vaccination and PD1-CTLA4 blockade) led to a survival of 8 years by now with a high quality of life, minimal residual disease, i.e. only a single, small paragastric recurrency despite the dedifferntiation of the tumor into a NEC G3 (Ki67 of 80%) incl. a non-functional stage.
©2017S. Karger AG, Basel
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