Articles related to NEUROENDOCRINE TUMORS (NETs)

The prognosis and therapy of grade 3 neuroendocrine neoplasms (NEN G3) depend on subgroup traits such as differentiation, proliferation rate, molecular profile, uptake on somatostatin receptor imaging, and primary site. Clinicians who treat this disease now have a better grasp of the prognosis and course of treatment for each entity thanks to the 2017 World Health Organization guidelines that split NEN G3 into neuroendocrine carcinomas (NEC) and NET G3. The distinction between NET G3 and NEC in upcoming trials and cancer registries will further improve prognosis and therapy options. Referral to a tertiary center is still of the utmost necessity at this time, considering the complexities of this disease. For the reasons described in this article, a referral also enables expert pathologic review, which is crucial. Further trials are undoubtedly necessary, considering the molecular heterogeneity of NEN G3.

The authors engaged in research to attempt to identify circulating biomarkers for pancreatic NETs, to improve tumor surveillance and quality of life. They examined the expression of circulating miRNA in the serum of MEN1 patients and found an inverse relationship between miR-3156-5p and MORF4L2 expression, representing a potential serum biomarker that could facilitate the detection of NET occurrence in MEN1 patients.

In patients with NETs with distant metastasis, 90Y radioembolization (90Y RE) might be an important treatment option; however, data to support clinical benefits are scarce. The authors purposed to analyze the use of 90Y RE in NET patients with hepatic metastases in an international, multicenter retrospective analysis. In reviewing response data, they conclude that 90Y RE could be an important alternative to peptide receptor radionuclide therapy as second-line treatment in patients with progressive liver-dominant disease pretreated with somatostatin analogs.

Following treatment of the 40 study patients with bevacizumab and atezolizumab, OS was observed in 4 patients with pNETs (20%) and 3 patients with epNETs (15%). The PFS was 14.9 months and 14.2 months in these cohorts, respectively. The findings suggest that clinical responses in patients with NET may follow treatment with the combination of bevacizumab and atezolizumab, with a PFS consistent with effective therapies.

Hutchmed’s submission was based primarily on two phase 3 trials conducted in China. Even though a bridging study conducted in the US that suggested safety and efficacy similar to that observed in the Chinese study population, FDA responded that a multiregional clinical trial “more representative of the US patient population and in accordance with US medical practice will be required” for resubmission.

This Radiopedia entry updated in April provides a concise summary of clinical and radiographic features of pNETs and an outline of classification and treatment. In addition to the summary information, there are a score of CT and PET CT studies to explore.