Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Aug 2024
Review[Systemic treatment of patients with metastatic neuroendocrine Neoplasia].
Due to the complexity and heterogeneity of metastatic NEN an interdisciplinary expert team should be involved in an individualized treatment strategy. SSA is the mainstay of antisecretory treatment in most functioning tumors. In antiproliferative intention SSA are first line treatment in receptor positive low proliferative NET. ⋯ In patients with metastatic NEC standard first line treatment (platinum + etoposide) has not changed for decades and new treatment options for this fatal disease are urgently needed. Benefit of immunotherapy is limited to a small subset of patients - new combinations are under investigation. This review summarizes the standard of care, criteria of treatment selection and new developments for systemic therapy in patients with metastatic NEN.
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Port systems provide safe venous access for patients with poor venous status and are essential for the long-term administration of drugs such as chemotherapeutics. However, they are not without complications. Port infection is a life-threatening situation; the infection rate in current studies varies from 0.8% to 7.5% and is significantly higher in cancer patients at 16-31%. The purpose of this SOP is to provide an overview of the management of port infections.
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About 0,5% of the population in Germany has a chronic hepatitis B virus (HBV) infection. Untreated, chronic HBV infection can progress to liver cirrhosis and hepatocellular carcinoma (HCC). ⋯ HBV/HDV co-infection leads to liver cirrhosis in approximately 50% of patients within 5-10 years. Since 2020, the cell entry inhibitor bulevirtide is available as a specific therapy for HBV/HDV co-infection.