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Neuroendocrine tumor metastasic treatment

Clement Chung
PURPOSE: Current strategies for managing neuroendocrine tumors (NETs) in adult patients are reviewed, with a focus on medication safety concerns. SUMMARY: NETs usually originate in the gastrointestinal or bronchopulmonary tract. Symptoms due to hormonal hypersecretion often occur in patients with foregut or midgut NETs or liver metastases. Surgical resection is recommended for most localized NETs, while systemic cytotoxic chemotherapy is typically used for high-grade and pancreatic tumors...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Brandon Cramer, Minzhi Xing, Hyun S Kim
PURPOSE: To determine the effect of Y radioembolization therapy on health-related quality of life (HRQOL) in patients with neuroendocrine tumor liver metastases (NETLM) in a prospective longitudinal study. MATERIALS AND METHODS: Baseline Short-Form 36 HRQOL scores were evaluated for significant change (P < 0.05) within the total patient population at 1, 3, 6, 12, and 24 months following Y using paired t-test. Overall survival (OS) times were calculated from first Y using the Kaplan-Meier method and analyzed using the log-rank test...
October 5, 2016: Clinical Nuclear Medicine
Timothy Weatherall, Jason Denbo, John Sharpe, Michael Martin, Thomas O'Brien, Rajib Gupta, Kenneth Groshart, Stephen Behrman, Paxton Dickson
INTRODUCTION: Nonfunctional, non-ampullary duodenal neuroendocrine tumors (dNETs) are rare neoplasms, and specific treatment recommendations are less clear than for other NETs. MATERIALS AND METHODS: We performed a retrospective review of patients (pts) with a diagnosis of dNET, excluding hormonally functional, ampullary, and high-grade tumors. Clinical data were evaluated to identify factors that might impact clinical staging and predictors of metastases. RESULTS: Thirty-six pts were identified...
October 14, 2016: World Journal of Surgery
James X Chen, Steven Rose, Sarah B White, Ghassan El-Haddad, Nicholas Fidelman, Hooman Yarmohammadi, Winifred Hwang, Daniel Y Sze, Nishita Kothary, Kristen Stashek, E Paul Wileyto, Riad Salem, David C Metz, Michael C Soulen
PURPOSE: The purpose of the study was to evaluate prognostic factors for survival outcomes following embolotherapy for neuroendocrine tumor (NET) liver metastases. MATERIALS AND METHODS: This was a multicenter retrospective study of 155 patients (60 years mean age, 57 % male) with NET liver metastases from pancreas (n = 71), gut (n = 68), lung (n = 8), or other/unknown (n = 8) primary sites treated with conventional transarterial chemoembolization (TACE, n = 50), transarterial radioembolization (TARE, n = 64), or transarterial embolization (TAE, n = 41) between 2004 and 2015...
October 13, 2016: Cardiovascular and Interventional Radiology
Karolína Drbalová, Kateřina Herdová, Petr Krejčí, Monika Nývltová, Svatopluk Solař, Lenka Vedralová, Pavel Záruba, David Netuka, Petr Bavor
Multiple Endocrine Neoplasia (MEN) is a condition in which several endocrine organs of an individual are affected by adenoma, hyperplasia and less often carcinoma, either simultaneously or at different stages of life. Two existing syndromes, MEN1 and MEN2 (2A, 2B), in literature is also mentioned MEN4, are associated also with other non-endocrine disorders. MEN1 (Wermer syndrome) affects the pituitary, parathyroid, and pancreatic area. 95 % of patients show very early manifestation of hyperparathyroidism, often before 40 years of age...
2016: Vnitr̆ní Lékar̆ství
Monica Ortenzi, Roberto Ghiselli, Maria Michela Cappelletti Trombettoni, Luca Cardinali, Mario Guerrieri
AIM: To analyze the outcomes of transanal endoscopic microsurgery (TEM) in the treatment of rare rectal condition like mesenchymal tumors, condylomas, endometriosis and melanoma. METHODS: We retrospectively reviewed a twenty-three years database. Fifty-two patients were enrolled in this study. The lesions were considered suitable for TEM if they were within 20 cm from the anus. All of them underwent an accurate preoperative workup consisting in clinical examination, total colonoscopy with biopsies, endoscopic ultrasonography, and pelvic computerized tomography or pelvic magnetic resonance imaging...
September 16, 2016: World Journal of Gastrointestinal Endoscopy
Mashaal Dhir, Ruchi Shrestha, Jennifer L Steel, J Wallis Marsh, Allan Tsung, Mitchel E Tublin, Nikhil B Amesur, Philip D Orons, Ernesto Santos, David A Geller
BACKGROUND: The majority of patients with neuroendocrine tumor liver metastases (NELM) present with multifocal disease and are not surgical candidates. We present our 20-year experience with transarterial chemoembolization (TACE) using streptozotocin (STZ) in patients with initially unresectable NELM. METHODS: Patients with unresectable NELM treated with TACE using STZ at a single institution from 1995 to 2015 were identified after institutional board approval. Imaging was independently reviewed by a radiologist to evaluate for RECIST 1...
September 23, 2016: Annals of Surgical Oncology
Steve Malangone, Christopher J Campen
A 60-year-old man initially presented with pain in the right upper quadrant in October 2010. A computed tomography (CT) scan of the abdomen pelvis completed at that time showed a mass at the junction of the body and tail of the pancreas and multiple large liver lesions. A CT-guided liver biopsy revealed low-grade neuroendocrine carcinoma. The patient was initially started on systemic treatment with sunitinib (Sutent) and octreotide. He developed intolerable side effects, including nausea and migraine. Therapy was discontinued in October 2011, when a CT scan revealed evidence of disease progression...
November 2015: Journal of the Advanced Practitioner in Oncology
Shane R Stecklein, Anuja Jhingran, Jennifer Burzawa, Preetha Ramalingam, Ann H Klopp, Patricia J Eifel, Michael Frumovitz
OBJECTIVE: To analyze patterns of recurrence and survival and identify prognostic factors in women with neuroendocrine cervical cancer (NECC). METHODS: We reviewed patients with International Federation of Gynecology and Obstetrics stage I-IVA NECC who were enrolled in the Neuroendocrine Cervical Tumor Registry and treated with curative intent. Event-free survival (EFS) and overall survival (OS) according to disease and treatment characteristics were analyzed using the Kaplan-Meier method...
September 16, 2016: Gynecologic Oncology
Alexander C Schippers, Federico Collettini, Ingo G Steffen, Gero Wieners, Timm Denecke, Marianne Pavel, Peter Wust, Bernhard Gebauer
PURPOSE: To evaluate efficacy of computed tomography (CT)-guided high-dose-rate brachytherapy (HDRBT) of neuroendocrine liver metastases (NELM) with the goal of local tumor control (LTC). MATERIALS AND METHODS: This retrospective study included all patients with unresectable NELM treated with CT-guided HDRBT between January 2007 and April 2015. Magnetic resonance imaging follow-up was performed 6 weeks after ablation and then every 3 months. The primary endpoint was LTC...
September 16, 2016: Journal of Vascular and Interventional Radiology: JVIR
Gustavo Felipe Luersen, W Wei, Eric P Tamm, Priya R Bhosale, Janio Szklaruk
PURPOSE: Our aim was to compare the interobserver and intraobserver variability for the measurement of the size of liver metastases in patients with carcinoid tumors with various magnetic resonance (MR) series. MATERIALS AND METHODS: In this retrospective institutional review board-approved study, 30 patients with liver metastases from a carcinoid primary had a complete MR examination of the abdomen at 1.5 T with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)...
September 2016: Journal of Computer Assisted Tomography
Laura E Donovan, Ashley V Arnal, Shih-Hsiu Wang, Yazmin Odia
Pituitary adenomas are the commonest intracranial tumor, but metastases are rare (0.2% yearly incidence) and portend poor prognosis. CAPecitabine and TEMozolomide improved outcomes for neuroendocrine tumors. However, no chemotherapy is approved for refractory pituitary carcinomas. Next-generation sequencing revealed an actionable mTOR pathway STK11 mutation in a woman with adrenocorticotropic hormone-secreting pituitary carcinoma refractory to six resections, radiation and CAPecitabine and TEMozolomide. Given efficacy in preclinical pancreatic cancer models with STK11 mutations, she received radiation and everolimus leading to clinical improvement and stability on MRI and PET for >6 months...
October 2016: CNS Oncology
Emilio Bertani, Nicola Fazio, Davide Radice, Claudio Zardini, Chiara Grana, Lisa Bodei, Luigi Funicelli, Carlo Ferrari, Francesca Spada, Stefano Partelli, Massimo Falconi
BACKGROUND: A low burden of disease represents an independent favorable prognostic factor of response to peptide receptor radionuclide therapy (PRRT) in patients affected by gastro-entero-pancreatic neuroendocrine tumors. However, it is not clear whether this is due to a lower diffusion of the disease or thanks to debulking surgery. METHODS: From 1996 to 2013 those patients diagnosed with G1-G2 pancreatic neuroendocrine tumor (PNET) and synchronous liver metastases who were not deemed eligible for liver radical surgery but were eligible to receive upfront PRRT were prospectively included in the study...
September 9, 2016: Annals of Surgical Oncology
Raj Mohan Paspulati, Amit Gupta
PET/computed tomography (PET/CT) is an established hybrid imaging technique for staging and follow-up of gastrointestinal (GI) tract malignancies, especially for colorectal carcinoma. Dedicated hybrid PET/MR imaging scanners are currently available for clinical use. Although they will not replace regular use of PET/CT, they may have utility in selected cases of GI tract malignancies. The superior soft tissue contrast resolution and depiction of anatomy and the functional information obtained from diffusion-weighted imaging (DWI) provided by MR imaging in PET/MR imaging are advantages over CT of PET/CT for T staging and follow-up of rectal carcinoma and for better characterization of liver lesions...
October 2016: PET Clinics
Bo Hyun Kim, In Joo Kim
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor derived from the thyroid C cells producing calcitonin. MTC accounts for 0.6% of all thyroid cancers and incidence of MTC increased steadily between 1997 and 2011 in Korea. It occurs either sporadically or in a hereditary form based on germline rearranged during transfection (RET) mutations. MTC can be cured only by complete resection of the thyroid tumor and any loco-regional metastases. The most appropriate treatment is still less clear in patients with residual or recurrent disease after initial surgery or those with distant metastases because most patients even with metastatic disease have indolent courses with slow progression for several years and MTC is not responsive to either radioactive iodine therapy or thyroid-stimulating hormone suppression...
September 2016: Endocrinology and Metabolism
Johann Dréanic, Céline Lepère, Mostafa El Hajjam, Hervé Gouya, Philippe Rougier, Romain Coriat
VIPoma is a rare neuroendocrine tumor (NET) with a high potential to develop hepatic metastases and poor prognosis. The primitive tumor is nonsymptomatic and usually localized within the pancreas. Liver metastasis drives the prognosis and induces profuse watery diarrhea or renal failure. We herein present severe renal failure or diarrhea in two patients hospitalized in intensive care justifying emergency treatment of liver metastasis. The two patients experienced severe diarrhea due to a hypersecretion of vasoactive intestinal peptide (VIP) from liver metastasis released into the blood circulation...
September 2016: Therapeutic Advances in Medical Oncology
Sonya C Hansen, Annette N Smith, Kendon W Kuo, Eric J Fish, Jey W Koehler, Gisela Martinez-Romero, Lenore M Bacek
An 8-year-old, female spayed Domestic Shorthair cat was presented to the Auburn University Emergency and Critical Care service for evaluation of pleural effusion and a suspected intrathoracic mass. Computed tomography was performed which confirmed the presence of a large intrathoracic mass, likely heart-based. Fine-needle aspirates were obtained and a cytologic diagnosis of a neuroendocrine tumor was made. Treatment with toceranib phosphate was briefly attempted at home by the owners. The cat died at home approximately 6 weeks after diagnosis...
September 2016: Veterinary Clinical Pathology
Matias Riihimäki, Akseli Hemminki, Kristina Sundquist, Jan Sundquist, Kari Hemminki
The epidemiology of metastases in neuroendocrine tumors (NETs) is virtually unknown. The present novel approach took use of two nationwide Swedish registers to assess the distribution of metastatic sites in comparison to adenocarcinoma. 7,334 patients with NET were identified from the Swedish Cancer Registry. Metastatic sites were identified from the National Patient and Cause of Death Registries. Sites of metastasis were investigated depending on the primary site of NET. The metastatic potential of NET was assessed...
December 15, 2016: International Journal of Cancer. Journal International du Cancer
Yohei Miyamae, Hisashi Shimizu, Atsushi Naganuma, Masaaki Aiba, Toshiyuki Tanaka, Tetsushi Ogawa, Akira Ogawa, Yoshiyuki Osamura
A 6 2-year-old woman visited our hospital with a complaint of anal bleeding and was diagnosed with rectal cancer. She underwent low anterior resection and D3 lymphadenectomy. The pathological diagnosis was shown as follows: Ra, Circ, type 2, por1, pSS, ly3, v1, pN2, pStage III b, and KRAS wild type. UFT/UZEL with polysaccharide K(PSK)was initiated as adjuvant chemotherapy after the operation. However, multiple liver metastases were found on CT after 3 courses of UFT/UZEL with PSK, and pathological reexamination revealed that the primary tumor was a neuroendocrine carcinoma...
August 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Yu Yu Thar, Poras Patel, Tiangui Huang, Elizabeth Guevara
Small cell neuroendocrine carcinoma (SNEC) is a rare form of malignancy. It mainly presents as bronchogenic neoplasm, and the extrapulmonary form accounts for only 0.1% to 0.4% of all cancers. These extrapulmonary tumors have been described most frequently in the urinary bladder, prostate, esophagus, stomach, colon and rectum, gall bladder, head and neck, cervix, and skin. Primary SNEC of the sinonasal tract is extremely rare with only less than 100 cases reported in the literature. Because of extreme rarity and aggressiveness of the tumor, the management for this entity varies considerably mandating multimodality approach...
2016: Case Reports in Oncological Medicine
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