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Article Open Access

Advances in the management of neuroendocrine tumours: Evidence from a systematic review

  • Authors:
    • Andreea-Daniela Caloian
    • Sorin Deacu
    • Miruna Cristian
    • Laura Mazilu
    • Lavinia Simona Neculai‑Candea
    • Andreea-Corina Ilie‑Petrov
    • Radu Adrian Nitu
    • Carmen Aida Ciufu
    • Nicolae Ciufu
  • View Affiliations / Copyright

    Affiliations: Department of Oncology and Haematology, University Ovidius Constanta, Faculty of Medicine, Ovidius Clinical Hospital, 905900 Constanta, Romania, Department of Histology, Faculty of Medicine, University Ovidius Constanta, 900470 Constanta, Romania, Department of Histopathology, St. James's Hospital, Dublin D08 NHY1, Ireland, Department of Radiology, University Ovidius Constanta, Faculty of Medicine, Ovidius Clinical Hospital, 905900 Constanta, Romania, Department of Surgery, University Ovidius Constanta, Faculty of Medicine, Ovidius Clinical Hospital, 905900 Constanta, Romania
    Copyright: © Caloian et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 54
    |
    Published online on: March 3, 2026
       https://doi.org/10.3892/br.2026.2127
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Abstract

Neuroendocrine tumours (NETs) are rare, biologically diverse neoplasms with a rising incidence due to improved diagnostics. Their management remains challenging, with multiple therapeutic strategies under evaluation. The present systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta‑Analyses guidelines. Literature searches were conducted across PubMed, Cochrane Library and ScienceDirect between January 2018 and July 2025. Eligible studies included randomized controlled trials, cohort studies and observational analyses involving adult patients with NETs. The primary outcomes were progression‑free survival (PFS) and overall survival (OS). A total of 271 studies were screened and 22 met the inclusion criteria. Median PFS across therapies ranged between 2 and 23 months, whereas OS ranged between 9.6 and 60 months, depending on treatment type. Dual checkpoint inhibitors (nivolumab plus ipilimumab) demonstrated durable benefits, with OS time exceeding 55 months in some cohorts, whereas peptide receptor radionuclide therapy (PRRT) achieved a median PFS time of 22.8 months compared with 8.5 months for high‑dose octreotide. Furthermore, targeted agents, such as sunitinib and nintedanib, improved PFS to ~11 months, with OS time extending beyond 30 months. Chemotherapy regimens such as CAPTEM yielded a PFS of 7‑11 months. In conclusion, the present study revealed that NET therapies show heterogeneous but clinically meaningful benefits. PRRT, targeted therapy and combination regimens were revealed to be associated with the most durable outcomes, whereas immunotherapy demonstrated promise in selected patients. Tailored approaches remain crucial to optimize survival and quality of life of patients.
View Figures

Figure 1

PRISMA framework. Flowchart
illustrating the literature search strategy and study selection
process according to PRISMA guidelines, including the number of
records identified, screened, excluded, and the final number of
studies included in the systematic review. PRISMA, Preferred
Reporting Items for Systematic Reviews and Meta-Analyses; NET,
neuroendocrine tumor.

Figure 2

Kaplan-Meier survival curve.
Kaplan-Meier survival analysis depicting overall survival over a
follow-up period of up to 60 months, stratified by treatment
modality. Censored observations are indicated, and survival
probabilities are expressed as cumulative proportions over
time.

Figure 3

Hazard ratios for PFS and OS. Forest
plot showing hazard ratios for progression-free survival and
overall survival across selected studies. The vertical reference
line at HR=1 indicates no treatment effect, with values below 1
suggesting a survival benefit and values above 1 indicating reduced
survival.
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Copy and paste a formatted citation
Spandidos Publications style
Caloian A, Deacu S, Cristian M, Mazilu L, Neculai‑Candea LS, Ilie‑Petrov A, Nitu RA, Ciufu CA and Ciufu N: Advances in the management of neuroendocrine tumours: Evidence from a systematic review. Biomed Rep 24: 54, 2026.
APA
Caloian, A., Deacu, S., Cristian, M., Mazilu, L., Neculai‑Candea, L.S., Ilie‑Petrov, A. ... Ciufu, N. (2026). Advances in the management of neuroendocrine tumours: Evidence from a systematic review. Biomedical Reports, 24, 54. https://doi.org/10.3892/br.2026.2127
MLA
Caloian, A., Deacu, S., Cristian, M., Mazilu, L., Neculai‑Candea, L. S., Ilie‑Petrov, A., Nitu, R. A., Ciufu, C. A., Ciufu, N."Advances in the management of neuroendocrine tumours: Evidence from a systematic review". Biomedical Reports 24.5 (2026): 54.
Chicago
Caloian, A., Deacu, S., Cristian, M., Mazilu, L., Neculai‑Candea, L. S., Ilie‑Petrov, A., Nitu, R. A., Ciufu, C. A., Ciufu, N."Advances in the management of neuroendocrine tumours: Evidence from a systematic review". Biomedical Reports 24, no. 5 (2026): 54. https://doi.org/10.3892/br.2026.2127
Copy and paste a formatted citation
x
Spandidos Publications style
Caloian A, Deacu S, Cristian M, Mazilu L, Neculai‑Candea LS, Ilie‑Petrov A, Nitu RA, Ciufu CA and Ciufu N: Advances in the management of neuroendocrine tumours: Evidence from a systematic review. Biomed Rep 24: 54, 2026.
APA
Caloian, A., Deacu, S., Cristian, M., Mazilu, L., Neculai‑Candea, L.S., Ilie‑Petrov, A. ... Ciufu, N. (2026). Advances in the management of neuroendocrine tumours: Evidence from a systematic review. Biomedical Reports, 24, 54. https://doi.org/10.3892/br.2026.2127
MLA
Caloian, A., Deacu, S., Cristian, M., Mazilu, L., Neculai‑Candea, L. S., Ilie‑Petrov, A., Nitu, R. A., Ciufu, C. A., Ciufu, N."Advances in the management of neuroendocrine tumours: Evidence from a systematic review". Biomedical Reports 24.5 (2026): 54.
Chicago
Caloian, A., Deacu, S., Cristian, M., Mazilu, L., Neculai‑Candea, L. S., Ilie‑Petrov, A., Nitu, R. A., Ciufu, C. A., Ciufu, N."Advances in the management of neuroendocrine tumours: Evidence from a systematic review". Biomedical Reports 24, no. 5 (2026): 54. https://doi.org/10.3892/br.2026.2127
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