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Surgery is the mainstay of treatment of NENs, but in recent decades there has been a considerable evolution of medical treatments that are used for locally advanced or metastatic disease not amenable to surgical resection. Long acting somatostatin analogues are the main therapeutic modality for patients with functioning and well-differentiated low grade NENs exhibiting symptomatic control and mainly stabilisation of tumour growth. Other systemic treatments include chemotherapy, molecular targeted agents, interferon-\u03b1, peptide receptor radionuclide therapy (PRRT), and immunotherapy. In addition, new agents such as telotristat may be used for the control of symptoms of carcinoid syndrome. The choice and\/or sequence of therapeutic agents should be individualized according to tumour origin and differentiation, disease burden, presence of clinical symptoms and patients\u2019 performance status in the context of a multidisciplinary approach. Recent advances in the molecular pathogenesis of NENs set the field for a more personalised treatment approach.<\/jats:p>","DOI":"10.1055\/a-1110-7251","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T23:38:31Z","timestamp":1582846711000},"page":"614-620","source":"Crossref","is-referenced-by-count":10,"title":["Medical Treatment of Gastrointestinal Neuroendocrine Neoplasms"],"prefix":"10.1055","volume":"52","author":[{"given":"Marina","family":"Tsoli","sequence":"additional","affiliation":[{"name":"1st Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystallenia","family":"Alexandraki","sequence":"additional","affiliation":[{"name":"1st Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Xanthopoulos","sequence":"additional","affiliation":[{"name":"1st Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Kassi","sequence":"additional","affiliation":[{"name":"1st Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece"},{"name":"Department of Biological Chemistry, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Kaltsas","sequence":"additional","affiliation":[{"name":"1st Department of Propaedeutic and Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/S1470-2045(07)70410-2","article-title":"Gastroenteropancreatic neuroendocrine tumours","volume":"9","author":"I M Modlin","year":"2008","journal-title":"Lancet Oncol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1159\/000441897","article-title":"Changes in the Epidemiology of Neuroendocrine Tumours","volume":"104","author":"I Huguet","year":"2017","journal-title":"Neuroendocrinology"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1200\/JCO.2007.15.4377","article-title":"One hundred years after \u201ccarcinoid\u201d: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States","volume":"26","author":"J C Yao","year":"2008","journal-title":"J Clin Oncol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1210\/jc.2015-2436","article-title":"Multiple and Secondary Hormone Secretion in Patients With Metastatic Pancreatic Neuroendocrine Tumours","volume":"101","author":"J Crona","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1210\/er.2003-0014","article-title":"The diagnosis and medical management of advanced neuroendocrine tumors","volume":"25","author":"G A Kaltsas","year":"2004","journal-title":"Endocr Rev"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1007\/s00428-010-0924-6","article-title":"The ENETS and AJCC\/UICC TNM classifications of the neuroendocrine tumors of the gastrointestinal tract and the pancreas: a statement","volume":"456","author":"G Kloppel","year":"2010","journal-title":"Virchows Arch"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1097\/PAS.0000000000000408","article-title":"The high-grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogenous and includes both well differentiated and poorly differentiated neoplasms","volume":"39","author":"O Basturk","year":"2015","journal-title":"Am J Surg Pathol"},{"key":"ref8","first-page":"16","article-title":"Classification of neuroendocrine neoplasms of the digestive system. 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