Every June, cancer specialists present their latest findings to their peers at the annual meeting of the American Society of Clinical Oncology (ASCO). Investigators must be selected to give podium presentations, poster presentations, or publish abstracts of their work in conference proceedings. It is both a competitive and prestigious opportunity to present to this influential gathering of more than 30,000 professionals. Many NETRF-funded researchers were on hand presenting their work, including Drs. Daniel Halperin, George Fisher, and Diane Reidy-Lagunes. We would like to thank them all for representing the Foundation.
At the 2017 conference in Chicago, we noted several interesting developments in NETs.
Emerging treatment approaches
Reidy-Lagunes and colleagues presented a poster on a phase I study of two somatostatin receptor 2 (sstr2) antagonists. In this trial of heavily treated NETs, preliminary data are promising for the use of 68Ga-OPS202/177Lu-OPS201 as a theranostic combination for imaging and therapy. Of the 19 patients treated, one had a complete response, six had partial responses, nine had stable disease, and three had progression of disease.
Wolin and colleagues presented a poster on the CLARINET core study of LAN in metastatic grade-1/2 enteropancreatic NETs. An analysis per tumor origin and prior therapy suggested beneficial antitumor effects for both subgroups.
Chauhan and colleagues published an abstract on the use of CAPTEM in NETs of unknown primary origin. Of the 12 patients treated, half showed tumor reduction, three had stable disease, and three showed disease progression at the first surveillance scan.
Improving quality of life
Fisher and colleagues presented a poster on LAN for control of carcinoid syndrome in patients with and without a prior response to OCT. Regardless of prior OCT use, patients showed improvement in flushing and diarrhea.
Weickert and colleagues published an abstract on the impact of telotrist ethyl, a treatment to reduce the frequency of carcinoid patients’ bowel movements, on patients’ weight. The study found patients taking the medication were more likely to gain weight than those on a placebo. Preventing unwanted weight loss caused by excessive diarrhea or vomiting may help improve treatment outcomes.
Halperin and colleagues published an abstract on the effects of somatostatin analogs (SSA) in patients with carcinoid syndrome. A survey of 118 patients showed the greatest improvement in quality of life in those who had taken SSAs for eight years or longer.
Improving predictive, prognostic, and diagnostic information
Mandair and colleagues presented a poster on phase IV of the NETTER-01 trial on predictive factors for PRRT response. The retrospective analysis of 307 patients over five years showed the greatest survival benefit from PRRT in patients who received treatment before the development of a large volume of disease, and who did not have radiological progression within the first 12 months of treatment.
Sim Lung and colleagues published an abstract on PRRT in 26 patients with grade-3 NETs facing a poor prognosis. The estimated median overall survival was 18 months from the start of PRRT, which authors reported as promising and worthy of further study.
Shen and colleagues presented a poster on a population-based study of pre-existing conditions, resource utilization, and healthcare costs before NET diagnosis in 12,052 older adults. In the year before NET diagnosis, these patients had healthcare costs three times that of non-NET patients.
Patel and colleagues published an abstract on the “Know Your Tumor” initiative by the Pancreatic Cancer Network and Perthera. The program facilitated tissue acquisition and analysis using multi-omics molecular profiling. Twenty-nine genomic alterations, associated with cancer, were identified in 15 patients, including p53, DAXX, RB1, PTEN, TSC2, in addition to alternations in genes encoding for DNA repair proteins (MLH1/ MSH1). A number of these alterations have been addressed with targeted therapies.
Beilei and colleagues published an abstract of a retrospective review of 1,004 newly diagnosed gastrointestinal NET patients. Those with carcinoid syndrome (25%) were more likely to be diagnosed with liver disorders, enlargement of lymph nodes, or abdominal mass than those without the syndrome.
We are grateful to all researchers and clinicians who presented their work on understanding and treating this disease. By helping to increase awareness of neuroendocrine tumors among the oncology community, we help to advance our ability to diagnose and treat NETs.