Pancreatic neuroendocrine tumors constitute about 2% of all gastrointestinal neoplasms. Approximately half of the pancreatic neuroendocrine tumors are nonfunctional. Due to lack of specific symptoms, most patients with nonfunctional pancreatic neuroendocrine tumors present with locally advanced or metastatic disease. Second primary malignancies are seen very rarely in these patients. Colon carcinoma ranks third in frequency among primary sites of cancer in both men and women in western countries. Presence of a metachronous colon adenocarcinoma in a patient with nonfunctional pancreatic neuroendocrine tumor has not been reported before. We present a patient who had an asymptomatic mass in the head of the pancreas, detected by ultrasonography in 1996. The patient did not consent to operation. In 2002, after the diagnosis of an unresectable, nonfunctional pancreatic neuroendocrine tumor, interferon alpha-2b and octreotide were started. A year after biological treatment, he refused further ...
PRIMARY OBJECTIVES:. I. To evaluate progression-free survival (PFS) associated with temozolomide alone or temozolomide and capecitabine in patients with advanced pancreatic neuroendocrine tumors.. SECONDARY OBJECTIVES:. I. To evaluate response rates (RR) associated with temozolomide alone or temozolomide and capecitabine treatment in patients with advanced pancreatic neuroendocrine tumors.. II. To evaluate overall survival (OS) associated with temozolomide alone or temozolomide and capecitabine in patients with advanced pancreatic neuroendocrine tumors.. III. To evaluate the toxicity associated with temozolomide alone or temozolomide and capecitabine treatment in patients with advanced pancreatic neuroendocrine tumors.. IV. To evaluate the usefulness of methyl guanine methyltransferase (MGMT) status (by immunohistochemistry [IHC] and promoter methylation) for predicting response in pancreatic neuroendocrine tumor patients treated with either temozolomide or temozolomide and capecitabine.. V. To ...
TY - JOUR. T1 - Liver transplantation for metastatic neuroendocrine tumors. T2 - Outcomes and prognostic variables. AU - Sher, Linda S.. AU - Levi, David M.. AU - Wecsler, Julie S.. AU - Lo, Mary. AU - Petrovic, Lydia M.. AU - Groshen, Susan. AU - Ji, Lingyun. AU - Uso, Teresa Diago. AU - Tector, A. Joseph. AU - Hamilton, Ann S.. AU - Marsh, J. Wallis. AU - Schwartz, Myron E.. PY - 2015/8/1. Y1 - 2015/8/1. N2 - Background Patient selection for liver transplantation for metastatic neuroendocrine tumors remains a topic of debate. There is no established MELD exception, making it difficult to obtain donor organs. Methods A multicenter database was created assessing outcomes for liver and multivisceral transplantation for metastatic neuroendocrine tumors and identifying prognostic factors for survival. Demographic, transplant, primary tumor site and management, pathology, recurrent disease and survival data were collected and analyzed. Survival probabilities were calculated using the Kaplan-Meier ...
Neuroendocrine pancreatic tumours grow slower and metastasise later than ductal and acinar carcinomas. The expression of the p53 tumour suppressor gene in pancreatic neuroendocrine tumour cells is unknown. Pancreatic neuroendocrine cell lines (n = 5) and human tumour tissues (n = 19) were studied for changed p53 coding sequence, transcription, and translation. Proliferative activity of tumour cells was determined analysing Ki-67 expression. No mutation in the p53 nucleotide sequence of neuroendocrine tumour cell was found. However, an overexpression of p53 could be detected in neuroendocrine pancreatic tumour cell lines at a protein level. As no p53 mutations were seen, it is suggested that post-translational events can also lead to an overexpression of p53.. ...
PRIMARY OBJECTIVES:. I. To evaluate if the addition of adjuvant everolimus to the R0 or R1 surgical resection of pancreatic neuroendocrine tumor metastases to the liver will result in an improvement in disease free survival.. SECONDARY OBJECTIVES:. I. To evaluate if the addition of adjuvant everolimus to the R0 or R1 surgical resection of pancreatic neuroendocrine tumor metastases to the liver will result in an improvement in overall survival.. II. To evaluate the toxicity associated with adjuvant everolimus following resection in patients with metastatic pancreatic neuroendocrine tumors to the liver.. OUTLINE: Patients are randomized to 1 of 2 treatment arms.. ARM A: Patients receive everolimus orally (PO) once daily (QD) on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.. ARM B: Patients receive placebo PO QD on days on days 1-28. Treatment repeats every 28 days for up to 12 courses in the absence of disease ...
New Data Shows Positive Chromogranin-A Biomarker Results in GI-NET Patient. Phase I/II Clinical Trial with TKM-PLK1 Ongoing in Patients with Advanced Gastrointestinal Neuroendocrine Tumors (GI-NET) or Adrenocortical Carcinoma (ACC). VANCOUVER, British Columbia, Oct. 4, 2013 (GLOBE NEWSWIRE) -- Tekmira Pharmaceuticals Corporation (Nasdaq:TKMR) (TSX:TKM), a leading developer of RNA interference (RNAi) therapeutics, today announced that it presented additional TKM-PLK1 data at the 6th Annual NET Conference hosted by the North American Neuroendocrine Tumor Society (NA-NETS) to be held in Charleston, South Carolina from October 4-5, 2013.. "We are pleased to present data at this conference reaching researchers and physicians treating patients who have been diagnosed with neuroendocrine tumors. We have an ongoing Phase I/II clinical trial with TKM-PLK1, with current enrollment targeting patients with either advanced Gastrointestinal Neuroendocrine Tumors (GI-NET) or Adrenocortical Carcinoma (ACC), ...
TY - JOUR. T1 - Appropriateness of systemic treatments in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors. AU - Strosberg, Jonathan R.. AU - Fisher, George A.. AU - Benson, Al B.. AU - Anthony, Lowell B.. AU - Arslan, Bulent. AU - Gibbs, John F.. AU - Greeno, Edward. AU - Iyer, Renuka V.. AU - Kim, Michelle K.. AU - Maples, William J.. AU - Philip, Philip A.. AU - Wolin, Edward M.. AU - Cherepanov, Dasha. AU - Broder, Michael S.. PY - 2015/2/28. Y1 - 2015/2/28. N2 - AIM: To evaluate systemic treatment choices in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors (PNETs) and provide consensus treatment recommendations. METHODS: Systemic treatment options for pancreatic neuroendocrine tumors have expanded in recent years to include somatostatin analogs, angiogenesis inhibitors, inhibitors of mammalian target of rapamycin and cytotoxic agents. At this time, there is little data to guide treatment selection and sequence. We therefore assembled a ...
TY - JOUR. T1 - Challenges in the diagnosis and management of well-differentiated neuroendocrine tumors of the lung (typical and atypical carcinoid). T2 - Current status and future considerations. AU - Wolin, Edward M.. PY - 2015/8/25. Y1 - 2015/8/25. N2 - Neuroendocrine tumors (NET) of the lung represent approximately 25% of all primary lung tumors and can be classified as low grade (typical carcinoids), intermediate grade (atypical carcinoids), or high grade (large cell neuroendocrine carcinoma or small cell lung carcinoma). Low- and intermediate-grade lung NET are increasingly recognized as biologically distinct from high-grade lung NET based on clinical behavior and underlying molecular abnormalities. This review summarizes current knowledge and challenges in the diagnosis and management of low- and intermediate-grade lung NET. Accurate histopathologic classification of lung NET is critical to determining appropriate treatment options but can be challenging even for experts. For low- and ...
In a large multi-institutional German study, the newer agent almost doubled the progression-free survival time over 90-Y-Dotatate and improved overall survival at 4 years from about 40% to approximately 70%, with the greatest effect seen in small bowel neuroendocrine tumors.5 The results led to the NETTER-1 study, "showing 177-Lu-Dotatate to be a very promising radioisotope, and we hope it gains approval," he commented.. As both speakers indicated, peptide receptor radionuclide therapy (90-Y-Dotatate or 177-Lu-Dotatate) is recommended for patients with somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors that are progressing despite standard-dose long-acting somatostatin analog therapy and for pancreatic neuroendocrine tumors progressing after somatostatin analog therapy or everolimus (Afinitor). That said, Dr. Strosberg noted there are no phase III data for a radiolabeled somatostatin analog in pancreatic neuroendocrine tumors, so where it should be positioned in the ...
New life-saving treatments for Carcinoid tumors | gastrointestinal neoplasms | neuroendocrine tumors in clinical trial on Study of Lanreotide in Patients With Metastatic Gastrointestinal Neuroendocrine Tumors Who Are Undergoing Liver-directed Radioembolization With Yttrium-90 Microspheres
Pancreatic neuroendocrine tumours (PTENs) are a heterogeneous group of tumours that develop from neuroendocrine cells of the pancreas [1]. Pancreatic neuroendocrine tumours comprise a rare group of pancreatic tumours and represent about 1-2% of all tumours developing within this organ [2]. The potential of neuroendocrine cells to produce and secrete peptides and/or biogenic amines affecting the clinical presentation of the disease thus determines their division into functioning and non-functioning pancreatic neuroendocrine tumours (functioning, F-PTEN and non-functioning, NF-PTEN). General accessibility of cross-sectional imaging of the abdomen has caused a significantly increasing rate of incidentally revealed non-functioning pancreatic neuroendocrine tumours in recent years. The group of NF-PTEN represents the majority of neuroendocrine tumours of the pancreas and is estimated at 60-90% [3]. An asymptomatic pattern of the disease associated with a lack of the peptide and/or biogenic amine ...
The U.S. Food and Drug Administration (FDA) has accepted and granted priority review to Ipsens supplemental New Drug Application (sNDA) for the somatostatin analog lanreotide (Somatuline Depot) 120 mg injection in the treatment of gastroenteropancreatic neuroendocrine tumors. The FDA designates priority review status to drug candidates that have the potential to offer a significant improvement in treatment compared to currently approved options. A decision is expected in early 2015.. In the United States, lanreotide is indicated for the long-term treatment of patients with acromegaly who have had an inadequate response to or cannot be treated with surgery and/or radiotherapy. The active substance in the drug is lanreotide acetate, a somatostatin analog that inhibits the secretion of several endocrine, exocrine, and paracrine amines and peptides.. CLARINET Trial. The regulatory submission was supported by the results of the investigational phase III CLARINET study, which demonstrated the ...
Neuroendocrine tumors (NETs) [carcinoids, pancreatic neuroendocrine tumors (pNETs)] are becoming an increasing clinical problem because not only are they increasing in frequency, but they can frequent
The establishment of new treatment options for chemo- and radiation-resistant NETs is essential because of the inefficacy of conventional chemotherapy. Medicinal herbs have come increasingly into the spotlight as complementary medicines. In the present study, we provide a first report of the antitumor activity of plant extracts from Christia vespertilionis, in which the ethylacetate fraction CV-45 showed significant antiproliferative and pro-apoptotic effects in MTC-SK as well as in KRJ-I cells.. It is known that many chemotherapeutic agents are able to induce apoptosis in cancer cells, as with sorafenib or 5-fluorouracil for human hepatoma cells (18,19). One goal in the establishment of new therapies against NETs is to define substances that have the ability to trigger anticancer effects and to induce apoptosis specifically in tumor cells, but not in normal cells.. In the human fibroblasts (HF-SAR) tested, the same concentration of CV-45 (10 μg/ml) as used for tumor cells did not inhibit ...
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Title:Advances in Systemic Therapy for Gastroenteropancreatic Neuroendocrine Malignancies. VOLUME: 10 ISSUE: 4. Author(s):Thorvardur R. Halfdanarson and Jonathan R. Strosberg. Affiliation:Mayo Clinic, Division of Medical Oncology, 200 First Street SW, Rochester, MN 55905, USA.. Keywords:Carcinoid tumors, neuroendocrine tumors, targeted therapy, therapy.. Abstract:Neuroendocrine tumors (NETs) are relatively uncommon. They typically arise in the gastrointestinal tract and lungs, and their incidence seems to be rising. Most patients have advanced disease at the time of diagnosis and many more will relapse after surgery. There is thus a great need for improvements in therapy for advanced neuroendocrine tumors. This article reviews the current therapy for both pancreatic NETs and non-pancreatic gastrointestinal NETs, and discusses recent advances in NET management with an emphasis on targeted therapy.. ...
Introduction: Small intestine neuroendocrine tumors (NETs) comprise well-differentiated NET (benign carcinoid), well-differentiated neuroendocrine carcinoma (malignant carcinoid) and poorly differentiated neuroendocrine carcinoma (NEC). The majority of NET patients have developed liver metastases at the time of diagnosis and surgery is then seldom curative. Novel predictive, diagnostic and prognostic markers are thus needed to improve our capabilities to diagnose and cure these tumors. We have previously identified six novel marker genes for neuroendocrine tumor cells by using Affymetrix microarrays and advanced bioinformatics. One of this markers, the paraneoplastic antigen Ma2 (PNMA2), which is normally expressed only in nervous tissue, can in the process of carcinogenesis be detected in tumors located outside the nervous system. The finding that Ma2 is expressed in small intestine neuroendocrine primary tumors and their metastases made it interesting to screen whether antibodies against Ma2 ...
In a recent Phase III trial, the targeted therapy Afinitor® (everolimus) more than doubled progression-free survival time among patients with advanced pancreatic neuroendocrine tumors (NET). Results of this study were presented at the 12th World Congress on Gastrointestinal Cancer.. Neuroendocrine tumors form from cells that release hormones in response to a signal from the nervous system. These tumors include carcinoid tumors, islet cell tumors, medullary thyroid carcinomas, pheochromocytomas, and Merkel cell carcinomas. Although they can occur in many different parts of the body, neuroendocrine tumors often develop in the digestive system.. Afinitor is an oral targeted therapy that works by inhibiting a protein known as the mammalian target of rapamycin (mTOR). The mTOR protein plays an important role in regulating cancer cell division and blood vessel growth. It was approved in 2009 for the treatment of selected patients with advanced renal cell (kidney) cancer.. This recent trial of ...
The combination of Afinitor® (everolimus) and Temodar® (temozolomide) appears to be active against advanced pancreatic neuroendocrine tumors. The details of this Phase I/II study were presented at the 2010 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium.[1]. Neuroendocrine tumors form from cells that release hormones in response to a signal from the nervous system. These tumors include carcinoid tumors, islet cell tumors, medullary thyroid carcinomas, pheochromocytomas, and Merkel cell carcinomas. Although they can occur in many different parts of the body, neuroendocrine tumors often develop in the digestive system.. Afinitor is an oral targeted therapy that works by inhibiting a protein known as the mammalian target of rapamycin (mTOR). The mTOR protein plays an important role in regulating cancer cell division and blood vessel growth. It was approved in 2009 for the treatment of selected patients with advanced renal cell (kidney) cancer.. The combination of ...
1. Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am. 2011;40:1-18 2. Modlin IM, Oberg K, Chung DC, Jensen RT, de Herder WW, Thakker RV. et al. Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol. 2008;9:61-72 3. Pearse AG. The cytochemistry and ultrastructure of polypeptide hormone-producing cells of the APUD series and the embryologic, physiologic and pathologic implications of the concept. J Histochem Cytochem. 1969;17:303-13 4. Reubi JC, Waser B. Concomitant expression of several peptide receptors in neuroendocrine tumours: molecular basis for in vivo multireceptor tumour targeting. Eur J Nucl Med Mol Imaging. 2003;30:781-93 5. Lee DY, Li KC. Molecular theranostics: a primer for the imaging professional. AJR Am J Roentgenol. 2011;197:318-24 6. Krenning EP, Bakker WH, Breeman WA, Koper JW, Kooij PP, Ausema L. et al. Localisation of endocrine-related tumours with ...
Introduction: Small intestine neuroendocrine tumors (NETs) comprise well-differentiated NET (benign carcinoid), well-differentiated neuroendocrine carcinoma (malignant carcinoid) and poorly differentiated neuroendocrine carcinoma (NEC). The majority of NET patients have developed liver metastases at the time of diagnosis and surgery is then seldom curative. Novel predictive, diagnostic and prognostic markers are thus needed to improve our capabilities to diagnose and cure these tumors. We have previously identified six novel marker genes for neuroendocrine tumor cells by using Affymetrix microarrays and advanced bioinformatics. One of this markers, the paraneoplastic antigen Ma2 (PNMA2), which is normally expressed only in nervous tissue, can in the process of carcinogenesis be detected in tumors located outside the nervous system. The finding that Ma2 is expressed in small intestine neuroendocrine primary tumors and their metastases made it interesting to screen whether antibodies against Ma2 ...
Background: Therapy monitoring of cancer treatment by contrast-enhanced CT (CECT), applying response evaluation criteria in solid tumors criteria version 1. 1 (RECIST 1.1) is less suitable for neuroendocrine tumors (NETs) which, when responding, tend to show stabilization rather than shrinkage. New methods are needed to further classify patients in order to identify non-responders at an early stage and avoid unnecessary adverse effects and costs. Changes in arterial tumor attenuation and contrast-enhancement could be used to identify the effect of therapy, perhaps even in early stages of treatment.Methods: Patients with metastatic pancreatic NETs (PNETs) receiving peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE underwent CECT at baseline, mid-treatment (PRRT cycles 3-5) and at follow-up, 3 months after the last PRRT cycle. At baseline CECT, the liver metastasis with the highest arterial attenuation was identified in each patient. The fold changes in arterial tumor attenuation
Purpose: Most patients with metastatic neuroendocrine tumors (NETs) have preserved hepatic synthetic function, and their providers may seek increased waitlist priority via MELD exception points. The roles of transplantation and MELD exceptions in these patients are controversial and gained national interest during the transplantation of Steve Jobs. In this study, we evaluate the association between receipt of MELD exception points and waiting list and post-transplantation outcomes in adult patients waitlisted for liver transplantation for metastatic neuroendocrine tumors (NETs).. Methods: We analyzed all adult patients waitlisted for liver transplantation for metastatic NETs between February 27, 2002 and June 4, 2014 through the United Network for Organ Sharing (UNOS). Waitlist outcomes (transplantation or waitlist removal for death or clinical deterioration) and post-transplantation survival were assessed based on primary exposure of receipt of MELD exception points. A multivariable model was ...
Management of neuroendocrine liver metastases is optimized with a multidisciplinary approach that includes medical oncology, surgery, and interventional radiology. This allows for various treatment options to be discussed by subspecialists and a comprehensive treatment plan employed. Image-guided therapies, namely thermal ablation and transarterial embolization, are used both as an adjunct to surgery and when surgery is not a viable option.4 These techniques have been shown to be effective for both local tumor control and symptom relief.5 This chapter reviews the various image-guided therapies currently available for NET liver metastases with regard to technique, efficacy, and available outcomes data. In addition, emerging and novel image-guided therapies are also reviewed. ...
We included 603 consecutive patients (325 men; age at diagnosis 63 ± 11 years [mean ± SD]) with histopathologically verified SI-NET, who were diagnosed between 1985 and 2010. Hospital charts were reviewed and were scrutinized for carcinoid heart disease (CHD), flush and/or diarrhea, proliferation by Ki-67 index, mesenteric lymph node metastases (m.lgllm), distant abdominal lymph node metastases (da.lgllm), liver tumor load (LTL), extra-abdominal metastases (EAM), locoregional resective surgery, as well as debulking of LTL, and adverse events after surgery. ...
Less than 5% of pancreatic tumors are Pancreatic Neuroendocrine Tumors (also called PNETs or islet cell tumors). Learn about PNETs and our patient services.
Pancreatic neuroendocrine tumors (pNETs) are a heterogeneous group of neoplasms with various clinical presentations. More than half of patients present with so-called nonfunctioning tumors with no hormone-related symptoms, whereas other tumors produce symptoms like gastric problems, ulcers, hypoglycemia, skin rash and diarrhea related to hormone production. The traditional treatment for pNETs over the last three decades has been cytotoxic agents, mainly streptozotocin plus 5-fluorouracil or doxorubicin. Most recently two new compounds have been registered worldwide for the treatment of pNETs, the mammalian target of rapamycin (mTOR) inhibitor everolimus and the tyrosine kinase inhibitor sunitinib. This paper concentrates on the use of mTOR inhibitors and the mechanisms of action. The mTOR pathway is altered in a number of pNETs. Everolimus (RAD001) is an orally active rapamycin analog and mTOR inhibitor. It blocks activity of the mTOR pathway by binding with high affinity to the cytoplasmic ...
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Neuroendocrine tumours (NETs) presenting as metastatic cancer of unknown primary site (CUP) are suspected to confer poorer prognosis compared to metastatic NETs of known primary site. We performed a retrospective, single centre study to determine the prognostic indicators in CUP-NETs compared to metastatic small intestinal NET (SiNET), before and after adjusting for factors known to affect overall survival. Subjects were selected from a departmental database of 1050 NET patients discussed by the Oxford neuroendocrine service between 2011 and 2019. Inclusion criteria were histologically proven NET with radiological evidence of metastatic disease at diagnosis. Survival time began from the date of histological diagnosis until the last known follow-up. The primary end-point was death. Patients were divided into 3 cohorts: 1) CUP-NET, no primary identified; 2) likely SiNET, radiological evidence of mesenteric/SiNET, and 3) histologically confirmed SiNET. Cox proportional hazards models were ...
Learn more about Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment (PDQ®) (Patients) from the National Cancer Institute at Siteman Cancer Center.
Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms that are thought to arise from neuroendocrine cells and their precursors located throughout the body. These tumors are characterized by variable but most often indolent biologic beha
Pancreatic neuroendocrine tumors form in hormone-making cells (islet cells) of the pancreas. The pancreas is a gland about 6 inches long that is shaped like a thin pear lying on its side. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The...
Abstract:. In recent years, much progress has been made in improving our therapies for patients with advanced pancreatic neuroendocrine tumors (panNETs). The recent approval of targeted drugs demonstrated that a better understanding of the genetic basis of panNETs may offer insights into precision medicine for our patients. In an effort to further our knowledge, our group has completed next-generation sequencing (NGS) in the tumor tissue of 81 patients with panNETs (95 tumor samples sequenced in total); 10 patients underwent NGS of their tumor tissue at multiple time-points. Our preliminary findings are novel and striking. We have built on prior findings and demonstrated that tumor grade and differentiation can be characterized through NGS, and in patients who had multiple tumor samples sequenced, we identified progression in tumor grade and the acquisition of new mutations (some, possible resistance mechanisms) in almost all patients. Working closely with our laboratory colleagues, we are ...
Background RADIANT-3 was a phase III study investigating the effect of the mammalian target of rapamycin inhibitor everolimus on progression-free survival (PFS) in patients with advanced pancreatic neuroendocrine tumors (pNET; Yao et al, NEJM, 2011). Everolimus significantly improved PFS compared with placebo (11 vs 4.6 months, P < .001). Here we investigate the predictive and prognostic effect of soluble VEGF pathway biomarkers among patients treated in this study.. Methods Baseline plasma levels of VEGF-A, PlGF, sVEGFR1, and sVEGFR2 were determined by ELISA using multiplexed MSD platform. The optimal cutoffs for these markers were explored using the "survival tree analysis" method. Interaction of treatment and baseline marker status (< or ≥ cutoff) was analyzed using a Cox proportional hazards model to assess predictive effects of these markers. P values and hazard ratios for prognostic effects were obtained using stratified log rank test and Cox proportional hazards model, stratified by ...
-Phase III trial showed Afinitor reduced risk of cancer progression by 65% vs. placebo in patients with advanced pancreatic neuroendocrine tumors (NET)[1], , , , -Afinitor gives patients with limited...
Mahvash disease is a novel pancreatic neuroendocrine tumor syndrome caused by inactivating glucagon receptor mutations. Its discovery was triggered by comparison of a pa..
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are unusual and relatively rare neoplasms. They characteristically synthetize, store and secrete a variety of peptides and neuroamines, which can lead to development of disctinct clinical syndromes. Clinical symptoms and presentations vary depending on the location and hormones produced by the tumor. The diagnosis of NETs is established by histological examination and the immunohistochemical detection of general neuroendocrine markers, such as chromogranin A (CgA) and synaptophysin. An update of the WHO classifi cation has resulted in a new classification dividing neuroendocrine neoplasms into neuroendocrine tumors (NETs) including G1 (Ki67 index ≤2%) and G2 (Ki67 index 3-20%) tumors and neuroendocrine carcinomas (NECs) with Ki67 index ,20%, G3. The different available therapeutic approaches, including surgery, liver-directed ablative therapies, peptide receptor radionuclide therapy, and systemic hormonal, cytotoxic or targeted therapy, ...
Published October 2011. ISBN: 978-1-78084-016-1. As a result of improved diagnostics such as new biomarkers, molecular imaging as well as new therapies based on randomized trials, neuroendocrine tumors are increasingly attracting the attention of physicians and scientists. In future, personalized medicine or theragnostics and large-scale sequencing will rapidly change the understanding of cancer biology and will help to identify new targets as well as explain the causes of drug resistance. This book covers the most recent information on neuroendocrine tumors in terms of classification, molecular profiles and diagnosis and different types of treatment for neuroendocrine tumors.. ...
Objective: Current systemic therapies for neuroendocrine tumours (NETs) do not provide sufficient control of tumour growth. However, efficient evaluation of novel drugs is hindered by the lack of a suitable preclinical animal model. Here we establish an orthotopic mouse model of pancreatic NET and use this model to study the action of ZK 304709, a first in class, oral Multi-target Tumour Growth InhibitorTM. ZK 304709 is an inhibitor of Cdks 1, 2, 4, 7 and 9, VEGF-RTKs1-3 and PDGF-RTKβ. Design: BON and QGP-1 human NET cells were used to study proliferation, survival and cell cycle distribution in vitro. For induction of orthotopic NETs, BON cells were injected into the pancreas of NMRInu/nu mice. Primary tumour growth and metastatic spread were recorded after nine weeks and apoptosis, microvessel density and lymphatic vessel density were determined. Results: ZK 304709 dose-dependently suppressed proliferation and colony formation of NET cells. Direct effects on NET cells were consistent with ...
177Lu-DOTATATE peptide receptor radionuclide therapy is administered to patients on an inpatient and outpatient basis for the treatment of well-differentiated, metastatic neuroendocrine tumours. Following administration, these patients present an external radiation hazard due to the gamma emissions of lutetium-177. The purpose of this study was to determine precautions to be observed by 177Lu-DOTATATE patients to restrict the dose received by patients family members to less than 5 mSv in 5 years and members of the public to less than 1 mSv per year in line with the current UK legislation. Retrospective data from therapeutic administrations of 177Lu-DOTATATE (Mallinckrodt Pharmaceuticals) and Lutathera® (Advanced Accelerator Applications) were analysed to measure activity retention at discharge. Patient dose rate measurements were assumed to follow the same activity decay curve as that derived from a least squares fit of geometric mean counts in planar whole-body scans performed at four time points
BACKGROUND: Well-differentiated (WD) and poorly differentiated (PD) pancreatic neuroendocrine neoplasms are biologically distinct entities with different therapies and prognoses. WD neoplasms with elevated proliferation (Ki-67 , 20%) have been shown to have an overlapping histology with PD neuroendocrine carcinomas. This study compared expert cytomorphologic assessments of differentiation in pancreatic neuroendocrine neoplasms in a multi-institutional study. METHODS: Fine-needle aspiration specimens from pancreatic neuroendocrine neoplasms (grade 2 [G2] and grade 3 [G3] according to the 2017 World Health Organization classification; n = 72) were diagnosed independently by 3 cytopathologists as WD or PD (poorly differentiated large cell type [PD-L] or poorly differentiated small cell type [PD-S]) purely on the basis of cytomorphology ...
Average patient age was 65.5 (range, 28-89) years; there were 25 males and 14 females. Nineteen tumors were located in the right colon, 11 in the left, and 9 were in the rectum. Three histopathologic patterns were identified: pure neuroendocrine (n = 11), predominantly neuroendocrine (n = 17), and cancers with equal exocrine and neuroendocrine differentiation (n = 7). Three cellular subtypes were seen: small-cell (n = 15), intermediate-cell (n = 15), and well-differentiated neuroendocrine cancers (n = 5). There was one Dukes A cancer, 7 Dukes B, 16 Dukes C, and 15 patients had metastases to distant sites at the time of diagnosis. As a group, neuroendocrine tumors have a poor prognosis: six-month survival was 58 percent, three-year survival was 15 percent, and five-year survival was 6 percent. Survival statistically correlated with tumor stage (P = 0.01) but not with age, sex, tumor location, histopathologic pattern, or neuroendocrine subtypes. Median survival for pure neuroendocrine carcinomas ...
Background/Aims: The tumor suppressor p53 is rarely mutated in gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) but they frequently show a strong expression of p53 negative regulators, r
Rare Cancer News & Clinical Trials » Trial - Neuroendocrine Cancers » TEMCAP in Grade 3 and Low Ki-67 Gastroenteropancreatic Neuroendocrine ...
When biopsies are obtained prior to tumor resection or a rectal NET is suspected on endoscopy, EUS can play a major role in pre-operative planning. EUS is an endoscope with a high frequency ultrasound at the tip, allowing for visualization of the histological layers of the luminal walls of the gastrointestinal tract [14]. Rectal NETs appear as smooth, hypoechoic, submucosal lesions on EUS imaging [15]. According to the European Neuroendocrine Tumor Society consensus guidelines, EUS is recommended to assess tumor size, depth of invasion, and the presence of lymph node involvement in order to determine the appropriate subsequent intervention (Fig. 2) [3]. In a study performed by Kobayashi et al., EUS correctly imaged the size and depth of fifty-two out of fifty-three lesions (98%), and these results were consistent with the histopathologic findings of the resected specimens [16]. EUS could accurately diagnose the depth of lesions as small as 2 mm in diameter [16]. These results were corroborated ...
Endocr Relat Cancer. 2012 Sep 14;19(5):615-23. doi: 10.1530/ERC-11-0382. Print 2012 Oct. Clinical Trial, Phase I; Research Support, Non-U.S. Govt
|i|Background:|/i| To assess prospectively the safety and efficacy of Yttrium-90 microspheres in patients with unresectable liver metastases from neuroendocrine tumors. |i|Materials
Contexte : Les tumeurs neuroendocrines (TNE) sont hétérogènes, et les tableaux et options thérapeutiques sont variables. À notre connaissance, il nexiste pas détudes randomisées et il y a peu détudes à long terme sur les résultats chez les patients. Le rôle du traitement chirurgical et médicamenteux de la maladie locale, régionale et métastatique continue dêtre évalué dans la littérature.. Méthodes : Nous avons procédé à une interrogation démographique du Registre provincial du cancer pour recenser les patients atteints de TNE gastro-intestinales provenant de lestomac, de lintestin grêle, du côlon et du rectum, diagnostiqués entre 1990 et 2005 et nous avons évalué les résultats.. Résultats : Nous avons examiné les données clinico-pathologiques des résultats enregistrés chez 530 patients atteints de TNE gastro-intestinales. Lincidence globale des TNE a augmenté de 11 par million à 19 par million pendant la période de létude. Le stade de la maladie et ...
Share on facebook Facebook Share on twitter Twitter Share on pinterest Pinterest Share on whatsapp WhatsApp Share on email Email One of the curious things about Neuroendocrine Cancer (NETs elsewhere in the text) is that it can very often exhibit one or more vague symptoms collectively known as a syndrome. Syndrome is an apt word to describe these complications as the most general meaning in medical terms is a group of symptoms that together are characteristic of a specific disorder or disease. Having a syndrome can often be the difference between having a functional condition or a non-functional condition - see more below. This frequently makes Neuroendocrine Cancer very difficult to diagnose quickly. Its a very devious disease. Its NOT all about Carcinoid Syndrome! Most people think of Carcinoid Syndrome ...
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