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Gastroenteropancreatic neuroendocrine tumor

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
Esben Andreas Carlsen, Nicola Fazio, Dan Granberg, Simona Grozinsky-Glasberg, Hojjat Ahmadzadehfar, Chiara Maria Grana, Wouter T Zandee, Jaroslaw Cwikla, Martin A Walter, Peter Sandor Oturai, Anja Rinke, Andrew Weaver, Andrea Frilling, Sara Gritti, Anne Kirstine Arveschoug, Amichay Meirovitz, Ulrich Knigge, Halfdan Sorbye
Peptide receptor radionuclide therapy (PRRT) is an established treatment of metastatic neuroendocrine tumors grade 1-2 (G1-G2). However, its possible benefit in high-grade gastroenteropancreatic (GEP) neuroendocrine neoplasms (NEN G3) is largely unknown. We therefore aimed to assess the benefits and side effects of PRRT in patients with GEP NEN G3. We performed a retrospective cohort study at 12 centers to assess the efficacy and toxicity of PRRT in patients with GEP NEN G3. Outcomes were response rate, disease control rate, progression-free survival (PFS), overall survival (OS) and toxicity...
February 1, 2019: Endocrine-related Cancer
John Ramage, Boris G Naraev, Thorvardur R Halfdanarson
177 Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is now approved for patients with advanced gastroenteropancreatic neuroendocrine tumors (NET), and it is therefore important to understand the efficacy and safety of PRRT in this patient population. PRRT efficacy and safety outcomes have frequently been summarized for patient populations with gastroenteropancreatic NET, but not specifically in patients with pancreatic NET (panNET). The pivotal phase 3 trial of 177 Lu-DOTATATE PRRT in NET was restricted to patients with a midgut primary site...
August 2018: Seminars in Oncology
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
E González-Flores, R Serrano, I Sevilla, A Viúdez, J Barriuso, M Benavent, J Capdevila, P Jimenez-Fonseca, C López, R Garcia-Carbonero
NENs are a heterogeneous family of tumors of challenging diagnosis and clinical management. Their incidence and prevalence continue to rise across all sites, stages and grades. Although improved diagnostic techniques have led to earlier detection and stage migration, the improved prognosis documented over time for advanced gastrointestinal and pancreatic neuroendocrine tumors also reflect improvements in therapy. The aim of this guideline is to update practical recommendations for the diagnosis and treatment of gastroenteropancreatic and lung NENs...
December 7, 2018: Clinical & Translational Oncology
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
Carlie S Sigel
Two-thirds of neuroendocrine neoplasms arising in the human body originate from the gastrointestinal system or pancreas. Gastroenteropancreatic neuroendocrine neoplasms are heterogeneous, comprising both well differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). The clinical presentation, molecular characteristics, and behavior are distinct for NETs and NECs. Fine-needle aspiration is an important modality for the primary diagnosis and staging of these neoplasms and can provide information of prognostic and therapeutic significance...
November 28, 2018: Cancer Cytopathology
Mauricio P Pinto, Matías Muñoz Medel, Diego Carrillo, Ignacio N Retamal, M Loreto Bravo, Yasna Valenzuela, Bruno Nervi, César Sánchez, Héctor Galindo, Carolina Ibañez, José Peña, Carlos Balmaceda, Jorge Madrid, Juan Briones, Javiera Torres, Flavia Nilo, Francisco J Guarda, Juan Carlos Quintana, Pilar Orellana, Sebastián Mondaca, Francisco Acevedo, Daniel Vicentini, Miguel Cordova-Delgado, Gareth I Owen, Marcelo Garrido
Neuroendocrine tumors (NETs) are relatively rare and highly heterogeneous neoplasms. Despite this, recent studies from North America and Central Europe have suggested an increase in incidence. In Latin America, NET data are scarce and scattered with only a few studies reporting registries. Our goal was to establish a NET registry in Chile. Here, we report the establishment and our first 166 NET patients. We observed a slight preponderance of males, a median age at diagnosis of 53 years and a median overall survival of 110 months...
November 22, 2018: Hormones & Cancer
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
(no author information available yet)
No abstract text is available yet for this article.
September 10, 2018: Medical Letter on Drugs and Therapeutics
Rajeswari Jayakumar, Sonali Lanjewar, Constantine A Axiotis
A major problem in neuroendocrine pathology is the identification and separation of aggressive low-grade neuroendocrine tumors (LGNETs) from those with a benign or more indolent behavior. Presently there are no known morphologic or molecular parameters which can predict how localized LGNETs will behave. The phosphatase and tensin homolog (PTEN) gene negatively regulates the PI3K-AKT-mTOR pathway and inhibits neoplastic cell survival and proliferation and has recently been identified as a neuroendocrine tumor differentiation marker...
September 2018: Annals of Clinical and Laboratory Science
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
John F Tierney, Sitaram V Chivukula, Xuanji Wang, Sam G Pappas, Erik Schadde, Martin Hertl, Jennifer Poirier, Xavier M Keutgen
BACKGROUND: Patients with gastroenteropancreatic neuroendocrine tumors often present with stage IV disease. Primary tumor resection in these patients remains controversial. Herein, we studied the impact of primary tumor removal, identified variables associated with prolonged survival for each neuroendocrine tumor subtype, and determined factors that influence surgeons to perform primary tumor resection. METHODS: Patients with metastatic gastroenteropancreatic neuroendocrine tumors diagnosed from 2004 to 2014 were identified from the National Cancer Database...
October 23, 2018: Surgery
Aaron T Scott, Patrick J Breheny, Kendall J Keck, Andrew M Bellizzi, Joseph S Dillon, Thomas M O'Dorisio, James R Howe
BACKGROUND: Cytoreductive surgery for neuroendocrine tumor liver metastases improves survival and symptomatic control. However, the feasibility of adequate cytoreduction in patients with many liver metastases remains uncertain. We compared patient outcomes based on the number of lesions treated to better define the efficacy of cytoreductive surgery for numerous neuroendocrine tumor liver metastases. METHODS: Patients undergoing hepatic cytoreductive surgery for gastroenteropancreatic neuroendocrine tumors were identified in our institutional surgical neuroendocrine tumor database...
October 18, 2018: Surgery
Jeffery Chakedis, Eliza W Beal, Alexandra G Lopez-Aguiar, George Poultsides, Eleftherios Makris, Flavio G Rocha, Zaheer Kanji, Sharon Weber, Alexander Fisher, Ryan Fields, Bradley A Krasnick, Kamran Idrees, Paula Marincola-Smith, Clifford Cho, Megan Beems, Timothy M Pawlik, Shishir K Maithel, Carl R Schmidt, Mary Dillhoff
INTRODUCTION: Patients with metastatic neuroendocrine tumor (NET) often have an indolent disease course yet the outcomes for patients with metastatic NET undergoing surgery for non-hormonal (NH) symptoms of GI obstruction, bleeding, or pain is not known. METHODS: We identified patients with metastatic gastroenteropancreatic NET who underwent resection from 2000 to 2016 at 8 academic institutions who participated in the US Neuroendocrine Tumor Study Group. RESULTS: Of 581 patients with metastatic NET to liver (61...
October 17, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Roberta Elisa Rossi, Clorinda Ciafardini, Valentina Sciola, Dario Conte, Sara Massironi
OBJECTIVES: Little is known about chromogranin A (CgA) during follow-up of gastroenteropancreatic neuroendocrine neoplasms. We hypothesized that serial CgA monitoring might be useful for the assessment of tumor progression, and we performed a systematic review of the literature and meta-analysis. METHODS: A bibliographical search was performed in PubMed using "chromogranin A" and "neuroendocrine tumors" and "follow-up" and "biomarker" to identify all pertinent articles published in the last 10 years...
November 2018: Pancreas
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...
October 11, 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
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