Review
Oncology
Kristen McClellan, Emerson Y. Chen, Adel Kardosh, Charles D. Lopez, Jaydira Del Rivero, Nadine Mallak, Flavio G. Rocha, Yilun Koethe, Rodney Pommier, Erik Mittra, Guillaume J. Pegna
Summary: This review summarizes the current treatments for neuroendocrine tumors and explores the cellular changes involved in treatment resistance. It provides an up-to-date summary of clinical findings regarding therapy-resistant neuroendocrine tumors and discusses potential strategies to overcome resistance.
Review
Oncology
Thorvardur R. Halfdanarson, Nadine Mallak, Scott Paulson, Chandrikha Chandrasekharan, Mona Natwa, Ayse Tuba Kendi, Hagen F. Kennecke
Summary: This article discusses the best practices in radioligand therapy for GEP-NETs patients, including imaging, clinical biochemistry, and tumor assessment criteria. Effective monitoring and surveillance measures are crucial for personalized clinical decision-making in individual clinical circumstances.
Review
Medicine, General & Internal
Baptiste Camus, Anne-Segolene Cottereau, Lola-Jade Palmieri, Solene Dermine, Florence Tenenbaum, Catherine Brezault, Romain Coriat
Summary: Radionuclide therapy for neuroendocrine tumors, targeting tumor cells with a large quantity of somatostatin receptors, is effective and has shown significant efficacy in metastatic midgut neuroendocrine tumors. Besides midgut tumors, pancreatic and pulmonary neuroendocrine tumors also seem to benefit from this treatment approach.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Denise A. Gococo-Benore, Justin Kuhlman, Ephraim E. Parent, Akash Sharma, Joseph Accurso, Ming Yang, Ayse Tuba Kendi, Geoff Johnson, Mohamad Bassam Sonbol, Timothy Hobday, Thorvardur R. Halfdanarson, Jason Starr
Summary: The aim of this study was to assess the risk of liver toxicity in patients with gastroenteropancreatic neuroendocrine tumors undergoing peptide receptor radionuclide therapy (PRRT) with a very high liver tumor burden. The results showed that only one out of fifteen patients with more than 75% liver involvement experienced liver function deterioration, with no clinical signs of liver failure. Therefore, PRRT may be considered a safe option for patients with extensive liver involvement.
JOURNAL OF NUCLEAR MEDICINE
(2023)
Review
Oncology
Changhoon Yoo, Chung Ryul Oh, Seung-Tae Kim, Woo Kyun Bae, Hye-Jin Choi, Do-Youn Oh, Myung-Ah Lee, Baek-Yeol Ryoo
Summary: Neuroendocrine tumors are malignancies that commonly arise from the gastrointestinal tract and pancreas, with curative resection being the main treatment for localized disease. Systemic therapy is necessary for relapsed or metastatic/unresectable cases. Specific guidelines for Korean patients have been developed considering geographical discrepancies and medical practices. Various treatment options including somatostatin analogs, targeted therapies, peptide receptor radionuclide treatments, and cytotoxic chemotherapies are addressed in the consensus review.
CANCER RESEARCH AND TREATMENT
(2021)
Article
Oncology
Alex J. Liu, Benjamin E. Ueberroth, Patrick W. McGarrah, Skye A. Buckner Petty, Ayse Tuba Kendi, Jason Starr, Timothy J. Hobday, Thorvardur R. Halfdanarson, Mohamad Bassam Sonbol
Summary: This study evaluated metastatic NET G3 response to different treatment regimens, showing that CAPTEM was the most commonly used treatment with clinically meaningful efficacy and disease control. FOLFOX or PRRT are other potentially active treatment options, while EP has limited activity with short-lived responses in NET G3.
Review
Oncology
Chanjuan Shi, Michael A. Morse
Summary: This article summarizes the treatment methods for advanced neuroendocrine tumors in the intestinal tract and pancreas, as well as the limitations in therapeutic resistance. Although the mechanisms of resistance are poorly understood, early studies suggest that combination therapy or the use of novel targeted drugs may be promising.
Article
Oncology
Kim R. Kennedy, John Harvey Turner, William B. G. MacDonald, Phillip G. Claringbold, Glenn Boardman, David T. Ransom
Summary: This study retrospectively analyzed the long-term toxicity and survival outcomes of 104 patients with advanced NETs treated with Lu-177-octreotate PRRT. The results showed that Lu-177-octreotate PRRT can provide durable responses and is well tolerated in long-term follow-up. However, the 6.7% long-term risk of MDS/leukemia needs to be balanced against the 21% PFS at 10 years.
Article
Radiology, Nuclear Medicine & Medical Imaging
Rahul Parghane, Manish Bhandare, Vikram Chaudhari, Vikas Ostwal, Anant Ramaswamy, Sanjay Talole, Shailesh Shrikhande, Sandip Basu
Summary: In GEP-NET patients, Lu-177-DOTATATE therapy can convert unresectable primary tumors into resectable in a moderate fraction of cases. The treatment leads to improved survival rates and progression-free survival, suggesting its potential as a neoadjuvant therapy option.
JOURNAL OF NUCLEAR MEDICINE
(2021)
Review
Pharmacology & Pharmacy
Apostolos Koffas, Christos Toumpanakis
Summary: Neuroendocrine neoplasms (NENs) are a heterogeneous group of neoplasms that require complex and individualized clinical decisions for management. Surgery is the only curative option, while high-grade advanced carcinomas should be primarily managed with platinum-based chemotherapy. Other treatment options include somatostatin analogs, interferon, targeted therapies, chemotherapy, peptide receptor radionuclide therapy, and locoregional treatment, all of which have associated treatment-related adverse events. However, the benefits offered by these treatments far outweigh the risks, leading to improved prognosis, symptom management, and quality of life for patients.
EXPERT OPINION ON DRUG SAFETY
(2021)
Article
Endocrinology & Metabolism
Elena Maria Vida Navas, Alberto Martinez Lorca, Aintzane Sancho Gutierrez, Lucia Sanz Gomez, Teresa Navarro Martinez, Enrique Grande Pulido, Alfredo Carrato Mena, Pablo Gajate Borau
Summary: Peptide receptor radionuclide therapy (PRRT) is effective in treating NETs with overexpressed somatostatin receptors, and salvage treatment with Lu-177-DOTATATE has shown good efficacy and low toxicity in some patients.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Lamiaa Zidan, Amir Iravani, Kira Oleinikov, Simona Ben-Haim, David J. Gross, Amichay Meirovitz, Ophra Maimon, Tim Akhurst, Michael Michael, Rodney J. Hicks, Simona Grozinsky-Glasberg, Grace Kong
Summary: This study retrospectively assessed the efficacy and safety of Lu-177-DOTATATE in treating lung NETs with high SSR expression. The results showed that Lu-177-DOTATATE had a good disease control rate and promising PFS and OS.
JOURNAL OF NUCLEAR MEDICINE
(2022)
Review
Endocrinology & Metabolism
Philip E. E. Harris, Konstantin Zhernosekov
Summary: Lu-177 is a radioactive isotope developed for PRRT treatment with high specific activity and advantages in waste disposal. PRRT has shown excellent efficacy in treating neuroendocrine tumors and can demonstrate receptor expression through PET imaging. Lu-177-DOTATATE has demonstrated superior efficacy and safety in clinical trials.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Oncology
Leonidas Apostolidis, Arianna Dal Buono, Elettra Merola, Henning Jann, Dirk Jaeger, Bertram Wiedenmann, Eva Caroline Winkler, Marianne Pavel
Summary: Neuroendocrine tumors grade 3 (NET G3) are a newly defined subgroup of tumors with unclear optimal treatment strategies. Research has shown that FOLFOX regimen offers the highest chance of tumor shrinkage, while temozolomide/capecitabine regimen provides the most durable tumor control.
Article
Oncology
Sho Hasegawa, Noritoshi Kobayashi, Damian Wild, Fesupplix Kaul, Naoki Okubo, Akihiro Suzuki, Yusuke Kurita, Shoko Takano, Atsushi Nakajima, Yasushi Ichikawa
Summary: This study aimed to analyze predictive factors associated with the rate of tumor shrinkage after PRRT for NETs. The results showed that previous treatment with cytotoxic agents and primary tumor of the pancreas were favorable factors for tumor shrinkage, while a primary tumor of the rectum was more resistant to shrinkage.