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Amr Mohamed, Jonathan R Strosberg
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are relatively rare neoplasms, characterized by a propensity to secrete hormones which cause distinct clinical syndromes. During the past decade, the systemic treatment landscape has improved significantly: new options include everolimus, an inhibitor of the mammalian target of rapamycin (mTOR), sunitinib, an angiogenesis inhibitor, and cytotoxic regimens such as capecitabine and temozolomide. Moreover, the recent approval of the radiolabeled somatostatin analog 177 Lutetium(Lu)-dotatate has had a significant impact on management of neuroendocrine malignancies...
February 8, 2019: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Shahad Alsadik, Siraj Yusuf, Adil Al-Nahhas
BACKGROUND: The incidence of pancreatic neuroendocrine tumours (pNETs) has increased considerably in the last few decades. The characteristic features of this tumour and the development of new investigative and therapeutic methods had a great impact on its management. OBJECTIVE: The aim of this review is to investigate the outcome of Peptide Receptor Radionuclide Therapy (PRRT) in treatment of pancreatic neuroendocrine tumours. METHODS: A comprehensive literature search strategy was used based on two databases (SCOPUS, and PubMed)...
February 1, 2019: Current Radiopharmaceuticals
Yelda Dere, Osman Ozkaraca, Gurcan Cetin, Ozcan Dere
OBJECTIVE: To design an application which can calculate Ki67 and compare its results with the traditional method in gastroenteropancreatic (GEP)-neuroendocrine tumors (NETs). STUDY DESIGN: Descriptive analytical study. PLACE AND DURATION OF STUDY: Faculties of Medicine and Technology of Mugla Sitki Kocman University between January 2015 to January 2016. METHODOLOGY: A new analyser for detecting the exact percentage of positive cells in images captured from different slides retrospectively selected from hospital records was designed and the concordance with results given by an expert pathologist was compared...
February 2019: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Taymeyah Al-Toubah, Stefano Partelli, Mauro Cives, Valentina Andreasi, Franco Silvestris, Massimo Falconi, Daniel Anaya Saenz, Jonathan Strosberg
New systemic treatments have improved the therapeutic landscape for patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs). While drugs such as everolimus, sunitinib, temozolomide, and 177Lutetium-dotatate are appropriate for patients with widespread disease progression, local treatment approaches may be more appropriate for patients with unifocal progression. Surgical resection, radiofrequency ablation (RFA), hepatic arterial embolization (HAE), or radiation, can control discrete sites of progression, allowing patients to continue their existing therapy, and sparing them toxicities of a new systemic treatment...
January 1, 2019: Endocrine-related Cancer
Eva Lesén, Daniel Granfeldt, Aude Houchard, Anthony Berthon, Jérôme Dinet, Sylvie Gabriel, Åse Björstad, Ingela Björholt, Anna-Karin Elf, Viktor Johanson
The objective was to estimate the cost-of-illness of grades 1 and 2 metastatic gastroenteropancreatic neuroendocrine tumours (GEP-NETs) in Sweden in 2013 in a population-based study including all patients diagnosed between 2005 and 2013. Data were obtained from national registers, and patients who utilised healthcare resources due to metastatic GEP-NETs in 2013 were included. The study included 478 patients (mean age 64 [SD=11] years, 51% men). The majority (80%) had small intestinal NET, 10% had pancreatic NET, and 41% had carcinoid syndrome...
January 16, 2019: European Journal of Cancer Care
Hallbera Gudmundsdottir, Páll Helgi Möller, Jon Gunnlaugur Jonasson, Einar S Björnsson
OBJECTIVE: To determine the incidence, distribution, and prognosis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) over the last 30 years and analyze changes over time. METHODS: All patients diagnosed with GEP-NETs in Iceland from 1985 to 2014 were identified through the Icelandic Cancer Registry and pathology laboratory records. Relevant clinical information was obtained from medical records. In order to assess trends, the study period was divided into two periods, 1985-1999 and 2000-2014...
January 13, 2019: Scandinavian Journal of Gastroenterology
Jordan M Cloyd, Bhavana Konda, Manisha H Shah, Timothy M Pawlik
Gastroenteropancreatic (GEP) neuroendocrine tumors (NETs) are a unique and complex neoplasm, exhibiting a wide spectrum of diverse clinical behaviors. The contemporary management of well-differentiated GEP-NETs is marked by the availability of a wide range of targeted therapies. Areas Covered: For patients with localized or oligometastatic disease, surgical resection remains the preferred approach and is associated with excellent long-term outcomes. For patients with unresectable but isolated liver metastases, multiple liver-directed therapies, including hepatic arterial based therapies and ablative techniques, exist...
December 24, 2018: Expert Review of Clinical Pharmacology
Mi Ri Lee, Cynthia Harris, Kiwoon Joshua Baeg, Anne Aronson, Juan P Wisnivesky, Michelle Kang Kim
BACKGROUND & AIMS: Although multiple studies have reported an increasing incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) over the past decades, there are limited national data on recent trends. Using a population-based registry, we evaluated GEP-NET incidence trends in the United States population from 1975 through 2012, based on age, calendar year at diagnosis, and year of birth. METHODS: GEP-NET cases from 1975 through 2012 were identified from the most recent version of the Surveillance, Epidemiology, and End Results registry using histologic and site codes...
December 20, 2018: Clinical Gastroenterology and Hepatology
Erin Laing, Nicole Kiss, Michael Michael, Karla Gough, Meinir Krishnasamy
BACKGROUND: Gastroenteropancreatic neuroendocrine tumors (GEP NETs) are a heterogeneous group of tumors with distinct effects on the body due to their potential to secrete hormones and peptides. The incidence and prevalence of GEP NETs in Australia are rising. During 2000-2006, the annual incidence was approximately 3.3 per 100,000 population. To date, there has been development of clinical practice and consensus guidelines for NETs covering best practice for diagnosis, treatment, and medical management; however, the supportive care needs and optimal nutritional management of patients affected by NETs remains underresearched, and evidence to guide clinical practice is lacking...
December 19, 2018: JMIR Research Protocols
Mark J C van Treijen, Catharina M Korse, Rachel S van Leeuwaarde, Lisette J Saveur, Menno R Vriens, Wieke H M Verbeek, Margot E T Tesselaar, Gerlof D Valk
Background: Available neuroendocrine biomarkers are considered to have insufficient accuracy to discriminate patients with gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs) from healthy controls. Recent studies have demonstrated a potential role for circulating neuroendocrine specific transcripts analysis-the NETest-as a more accurate biomarker for NETs compared to available biomarkers. This study was initiated to independently validate the discriminative value of the NETest as well as the association between tumor characteristics and NETest score...
2018: Frontiers in Endocrinology
Miguel Sampedro-Núñez, Ana Serrano-Somavilla, Magdalena Adrados, José M Cameselle-Teijeiro, Concepción Blanco-Carrera, José Manuel Cabezas-Agricola, Rebeca Martínez-Hernández, Elena Martín-Pérez, José Luis Muñoz de Nova, José Ángel Díaz, Rogelio García-Centeno, Javier Caneiro-Gómez, Ihab Abdulkader, Roberto González-Amaro, Mónica Marazuela
The immune checkpoint based therapy targeting the programmed death-1 (PD-1) receptor and its PD-L1 ligand has recently been approved for the therapy of different malignant conditions, but not yet for gastroenteropancreatic neuroendocrine tumors (GEP-NETs). In this context, we evaluated the expression of PD-1 and PD-L1 in GEP-NETs and its potential correlations with clinical outcomes. Expression of PD-1/PD-L1 was analyzed by immunohistochemistry in 116 GEP-NETs and 48 samples of peritumoral tissue. In addition, the expression of these molecules was assessed by flow cytometry in peripheral blood mononuclear cells (PBMC) from patients with GEP-NETs (n = 32) and healthy controls (n = 32) and in intratumoral mononuclear cells (TMCs) (n = 3)...
December 13, 2018: Scientific Reports
Junho Kang, Changhoon Yoo, Hee-Sang Hwang, Seung-Mo Hong, Kyu-Pyo Kim, Sun Young Kim, Yong-Sang Hong, Tae Won Kim, Baek-Yeol Ryoo
Lanreotide autogel is a long-acting somatostatin analogue with proven efficacy and safety in patients with well-differentiated (WD) gastroenteropancreatic-neuroendocrine tumors (GEP-NETs) in a prior randomized phase III trial (CLARINET). However, the CLARINET study only enrolled patients with Ki-67 index <10%, and few patients of Asian ethnicity were included. We retrospectively analyzed the efficacy and safety of lanreotide in Korean patients with GEP-NETs in the daily practice setting. Between January 2015 and May 2018, 64 patients with metastatic WD GEP-NETs received lanreotide at Asan Medical Center, Seoul, Korea...
December 10, 2018: Investigational New Drugs
Luigi Barrea, Barbara Altieri, Giovanna Muscogiuri, Daniela Laudisio, Giuseppe Annunziata, Annamaria Colao, Antongiulio Faggiano, Silvia Savastano
Neuroendocrine tumors (NETs) are rare neoplasms mostly originating from the gastroenteropancreatic tract (GEP-NETs). Data regarding nutritional status in GEP-NET patients are limited. The aim of the study was to investigate the nutritional status and adherence to the Mediterranean Diet (MD) in GEP-NET patients and to correlate them with tumor aggressiveness. A cross-sectional case-control observational study was conducted enrolling 83 patients with well-differentiated G1/G2 GEP-NETs after resection, as well as 83 healthy subjects, age, sex and body mass index-matched...
December 1, 2018: Nutrients
Yi Wang, Kun Huang, Jie Chen, Yanji Luo, Yu Zhang, Yingmei Jia, Ling Xu, Minhu Chen, Bingsheng Huang, Dong Ni, Zi-Ping Li, Shi-Ting Feng
Objective: We propose a computer-aided method to assess response to drug treatment, using CT imaging-based volumetric and density measures in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and diffuse liver metastases. Methods: Twenty-five patients with GEP-NETs with diffuse liver metastases were enrolled. Pre- and posttreatment CT examinations were retrospectively analyzed. Total tumor volume (volume) and mean volumetric tumor density (density) were calculated based on tumor segmentation on CT images...
2018: Contrast Media & Molecular Imaging
Eva Lesén, Åse Björstad, Ingela Björholt, Tom Marlow, Entela Bollano, Marion Feuilly, Florence Marteau, Staffan Welin, Anna-Karin Elf, Viktor Johanson
OBJECTIVES: To quantify healthcare resource use (HRU) and costs in relation to carcinoid syndrome (CS) and carcinoid heart disease (CHD) in a real-world setting, and to provide perspective on treatment patterns. MATERIALS AND METHODS: Patient data and HRU were collected retrospectively from three Swedish healthcare registers. Adult patients diagnosed with metastatic gastroenteropancreatic neuroendocrine tumors (GEP-NETs) grade 1 or 2 and CS who purchased somatostatin analogs (SSAs), and experienced controlled (defined by SSAs use) and uncontrolled (defined by SSAs dose escalation) CS for ≥8 months during the study period were included...
November 19, 2018: Scandinavian Journal of Gastroenterology
Rohit Dhingra, Julie Y Tse, Muhammad Wasif Saif
Background: Gastroenteropancreatic neuroendocrine tumors are neoplasms commonly found within the gastrointestinal tract that originate from endocrine cells. These are slow progressive tumors and often metastasize to other elements of the gastrointestinal tract including the liver. Consequently, these tumors release hormones including serotonin and/or histamine that are responsible for the symptoms including intermittent flushing and diarrhea. Metastasis of gastroenteropancreatic neuroendocrine tumors, although rare, is possible and may extend to local lymph nodes and viscera...
September 2018: JOP: Journal of the Pancreas
Fatih Mert Dogukan, Banu Yilmaz Ozguven, Rabia Dogukan, Fevziye Kabukcuoglu
Gastroenteropancreatic neuroendocrine tumors (GEP-NET) are classified according to tumor grade. Ki-67 and mitotic count are the two determinants of this classification. Therefore, Ki-67 scoring becomes very important in classifying the patients accurately. Eye-balling, counting of cells through the microscope, automated image analysis systems, and manual counting of printed image are the four major scoring methods in use. The aim of this study is to show the agreement between monitor-image method (MIM) and printout-image method (PIM) of Ki-67 scoring...
October 26, 2018: Endocrine Pathology
Xavier M Keutgen, Erik Schadde, Rodney F Pommier, Thorvardur R Halfdanarson, James R Howe, Electron Kebebew
Over 50% of patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have stage IV disease at presentation and the most likely organ to be affected by metastases is the liver. Hepatic involvement and hepatic tumor burden is a key prognostic factor affecting survival of these patients and 80% eventually die of liver failure due to tumor dissemination within the liver. This commentary explores the efficacy and limitations of systemic treatments in patients with GEP-NETs and liver metastases. Landmark randomized trials using systemic therapies including sandostatin (PROMID), lanreotide (CLARINET), everolimus (RADIANT 3 and 4), sunitinib and Peptide Receptor Radionuclide Therapy (NETTER-1) have not shown efficacy in reducing liver tumor burden in patients with stage IV GEP-NETs with liver metastases as outlined in this review...
August 2018: Seminars in Oncology
Ashwini Kalshetty, Anant Ramaswamy, Vikas Ostwal, Sandip Basu
BACKGROUND AND AIMS: Functioning and symptomatic disease resistant to conventional therapies constitutes a subset amongst neuroendocrine tumors (NETs) that are commonly considered for peptide receptor radionuclide therapy (PRRT). The aim of this study was to evaluate the efficacy of Lu-DOTATATE PRRT in this group with objective assessment criteria. MATERIALS AND METHODS: A total of 46 patients with refractory or progressive symptomatic GEP-NETs (previously treated at various stages with long-acting octreotide, chemotherapy, multikinase inhibitors, etc...
December 2018: Nuclear Medicine Communications
Thomas Cuny, Wouter de Herder, Anne Barlier, Leo J Hofland
Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a group of heterogeneous tumors whose incidence increased over the past few years. Around half of patients already present with metastatic disease at the initial diagnosis. Despite extensive efforts, cytotoxic and targeted therapies have provided only limited efficacy for patients with metastatic GEP-NETs, mainly due to the development of a certain state of resistance. One factor contributing to both the failure of systemic therapies and the emergence of an aggressive tumor phenotype may be the tumor microenvironment (TME), comprising dynamic and adaptative assortment of extracellular matrix components and non-neoplastic cells, which surround the tumor niche...
November 1, 2018: Endocrine-related Cancer
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