NET Cancer Medical Reading

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NET Cancer Medical Reading

Aimed at Doctors on the Latest Research–But some can be understood by laypeople

These are posted in roughly chronological order, with the most recent information at the top and the least recent toward the bottom.

A Practical Guide to Supportive Care of Patients with Functional Neuroendocrine Tumors

Here is the latest on treatments for NET cancers for the medical community. The paper is by carcinoid/NET specialist Dr. Lowell B. Anthony and reviews the progress made in the last 30 years on NET cancer. Much of that progress really has come over just the last five years.

Primary Neuroendocrine Tumor of the Left Hepatic Duct: A Case Report with Review of the Literature

This is an exceedingly rare form of NET cancer with only 77 recorded cases. Interestingly, when the tumor could not be removed, treatment with Octreotide appears to have shrunk the tumor.

Merkel Cell Carcinoma Prognosis Linked to Vitamin D

A Finnish study argues Vitamin D deficiency is common in Merkel Cell Carcinoma–a skin cancer form of NET cancer. Another study reported here says both Merkel Cell and Melanomas tend to form on the left side of the body. While you have to register to access the study, once that is done, the information is free.

Pancreatic Neuroendocrine and Carcinoid Tumors: What’s New, What’s Old, and What’s Different?

The good news from this June 2012 review paper is that we have drugs that seem to slow the progress of pancreatic NET. The bad new is they don’t seem to work very well on other NET cancers. There are some promising therapies in the pipeline but NET cancer generally still seems like a tough nut to crack.

Molecular evidence for the bi-clonal origin of neuroendocrine tumor derived metastases

This is a pretty complex genetic argument based on in vitro studies.

Small, nonfunctioning, asymptomatic pancreatic neuroendocrine tumors

This article looks at the differences between operating on small pancreatic NET cancer tumors and doing other treatments.

Association of Type-O Blood with Neuroendocrine Tumors in Multiple Endocrine Neoplasia Type 1

Those with Type O blood appear to have a greater chance of developing active NET cancers.

Cystic pancreatic neuroendocrine tumors: a clinicopathologic study.

As though NET cancer is not hard enough to diagnose, here is a new wrinkle.

Randomized crossover study in patients with neuroendocrine tumors to assess patient preference for lanreotide Autogel® given by either self/partner or a health care professional

Independence is a major issue for many NET cancer patients. This study looks at self/partner injections of a specific agent used to treat NET cancer symptoms. It found no difference in safety or efficacy when the drug was given by the patient or a partner at home compared to the same drug given by a nurse at a medical facility

New Perspectives in the Treatment of Neuroendocrine Tumours

This paper from the International Journal of Cancer Research and Treatment addresses the European Standard of Care, which includes RPPT as an option for some tumors. This links to the abstract. To read the full article requires a subscription or payment of a fee.

Liposomal doxorubicin-based treatment in a preclinical model of adrenocortical carcinoma – Abstract

This is  a possible new drug for treating this rare form of NET cancer. The lab work with a mouse model is done. The next step is a Phase I clinical trial that has not yet been approved.

Lexicon Phase 2 Trial Of Anti-Tumor Drug Meets Primary Endpoint, Begins Phase 3

Results of Phase II on telotristat etiprate for carcinoid tumors are in and look good. The drug is palliative and not a cure, but it is headed for Phase III.

Concomitant intraductal papillary mucinous neoplasm and neuroendocrine tumor of the pancreas

These two should rarely exist together but evidence is mounting that the two often occur together. This paper from Oncology Letters looks at a single case of this combination of NET cancer with this other cancer.

The Role of 68Ga-DOTATATE PET/CT in Suspected Neuroendocrine Tumors

This is the abstract to a new paper in the Journal of Nuclear Medicine on a method for detecting NET cancers.

Ampullary neuroendocrine tumor presenting with biliary obstruction and gastric outlet obstruction

This is a report on a single patient from the Indian Journal of Medicine on a palliative procedure for an ampullary NET cancer.

Small Bowel Carcinoid Tumors: Slides from presentation at Vanderbilt

These slides are from a presentation for medical students at Vanderbilt University.

Latest Standard of Care on NET cancer (2012)

The standard of care for NET cancer was updated in the summer of 2012. If you are a doctor, this is the latest information on the treatment and management of NET cancers.

Everolimus and mTOR inhibition in pancreatic neuroendocrine tumors

This is a review paper of several studies on the use of Everolimus and other mTOR inhibitors on pNETs and other NET cancers. It includes some information on combination of MTORs with both Octreotide and Pasireotide.

Neuroendocrine tumors of the appendix in children and adolescents

While NETs are rarely found in young people, it does happen–usually after they have been operated on for something else. How rare are they? Who knows. But this study is based on 237 cases and talks about tumor size as a predictor of spread.

Free Pharmacology Hours for APNs- Neuroendocrine Tumors

If you are an oncology nurse–or a nurse encountering NET for the first time, this short course will bring you up-to-date on what the standard of care is currently. The course is in place until early December and offers a FREE 1.5 CEUs.

Grading of Neuroendocrine Tumors With Ki-67 Requires High-quality Assessment Practices

This study suggests that grading of NETs through Ki-67 works best when done by a public domain computer program rather than relying on the human eye.

 Neuroendocrine Tumors of the Lung

July 31, 2012 Cancers published a special issue on Neuroendocrine Tumors. This 22 page section from that edition of the magazine discusses NETs of the lung in great detail. The piece is not well-written and is very dense in terms of medical language but is well worth the time for medical professionals and patients with lung NETs. It claims that ALL invasive lung tumors are 20-25 percent made up of NETs. If this be true then this, added to the presence of NETs in close proximity to aggressive prostate tumors, increases the evidence for my hypothesis that NETs may be responsible for aggressive behavior in other cancers.

First human trial of new imaging technique in Denmark

This new technique involves less radiation exposure while providing better imaging quality for NETs.

Prospective Study of Bevacizumab Plus Temozolomide in Patients With Advanced Neuroendocrine Tumors

Conclusion Temozolomide and bevacizumab can be safely administered together in patients with advanced NETs, and the combination regimen appears promising for patients with pancreatic NETs. Studies evaluating the relative contributions of these two agents to the observed antitumor activity are warranted.

Varying malignant potential of appendiceal neuroendocrine tumors: Importance of histologic subtype

This is the abstract of an article in the Journal of Surgical Oncology. To read the full article you must have other a subscription or pay a fee.

The article’s conclusion: Appendiceal NETs represent a spectrum of disease with varying malignant potential: MCT (low), GCT (intermediate), and CGCC-A (high). GCTs represent the most common subtype, whereas CGCC-As place the patient at highest risk for regional and distant metastases and have the worst prognosis. J. Surg. Oncol © 2012 Wiley Periodicals, Inc.

This links to the abstract of the paper. You will need a subscription or to pay a fee to read the whole thing.

Attenuation of the Rb pathway in pancreatic neuroendocrine tumors due to increased Cdk4/Cdk6

Conclusions: Inactivation of the Rb pathway was indicated for most Pan-NETs. Gene amplification and overexpression of Cdk4 and Cdk6 suggests that patients with Pan-NETs may respond strongly to Cdk4/6 inhibitors that are entering clinical trials.

Baseline demographics of patients with neuroendocrine tumors

Diagnostic strategies, management paradigms, and clinical outcomes of patients with neuroendocrine tumors (NETs) are diverse and poorly characterized. The National Comprehensive Cancer Network (NCCN) created a comprehensive longitudinal database to characterize patients treated for NETs at seven participating institutions. Preliminary results from the database are reported. This links to the abstract of the paper. You will need a subscription to read the whole thing.

Refining the Use of Everolimus for Neuroendocrine Tumors

A review of data from a previous study shows Everolimus may be more effective in treating NETs than previously thought. The paper was presented at the Jan. 19, 2012 Gastrointestinal Cancers Symposium.

Expression of a Neuroendocrine Gene Signature in Gastric Tumor Cells 

This paper on genetics involved in NETs is very dense but argues that inactive genes that are supposed to control tumor suppressor genes may be part of the problem.

Niiki Pharma Announces the Completion of Phase I Dose Escalation for First-in-Man Anti-Cancer Agent NKP-1339

This new drug showed positive results in NETs. It is off in the distance in terms of approvals.

Gut has article on new NET treatment guidelines

This links only to the abstract. To view the full article you need a subscription or must purchase the article.

Management of NETs of unknown primary 

This article from Medscape details symptoms and methods of tracking down primary tumors and what to do if one cannot be found. It will be highly useful to Primary Care physicians and to oncologists encountering the disease for the first time. It is very up-to-date–and highly accessible to many non-physicians.

Lancet publishes results from two drug trial

Researchers combined octreotide and everolimus to improve patient survival.

Nature Review article looks at NETs of the gut

This article reviews current knowledge of NETs of the GI tract. It requires a payment to see the full article.

Article argues for combining Everolimus with somastatin analogs

In an article in the Journal of Clinical Endocrinology & Metabolism published online before the magazine went to press, a group of doctors discusses the use of the newly approved Everolimus in combination with somastatin analogs. The full text of the article is not yet in print. This is a quick summary of their findings.

Temozolomide and Thalidomide for Neuroendocrine Tumors: A Retrospective Report

This is an abstract of a paper presented the 2011 Gastrointestinal Oncology conference. It replicates results of an earlier study.

Hepatic arterial embolization for the treatment of metastatic neuroendocrine tumors 

This downloads a very recent paper on liver arterial embolization and its impact on overall survival and symptom reduction. It argues this method leads to significantly increased survival and reduction in symptoms for NET patients where removal of metastases in the liver is not possible. The paper is well-written and not overly difficult to understand for laypeople, though aimed prima rally at doctors.

OctreoPharm gets Orphan status in Europe for new NET test using Gallium

The European Medicines Agency has granted an Orphan Drug Designation to a Berlin based company for diagnosis of gastroentero-pancreatic neuroendocrine tumors. This links to the press release. The product is called SOMscan and uses Gallium-68.

Q & A on pancreatic NET with Dr. Erik E. Custem

THis is a pretty basic interview on NET that starts in the pancreas. It is in somewhat more difficult language than some will be comfortable with. But the piece is pretty straight-forward.

OctreoPharm Sciences GmbH granted global license for Oncology Diagnostic product

The new Gallium-68 labeled contrast agent in the license makes neuroendocrine tumors easier to see.

Neuroendocrine Liver Tumors and Orthotopic Liver Transplantation

This downloads a paper reviewing the success of liver transplants in NETs that have metastasized to the liver. The paper argues the approach has better results than the current standard treatments for patients in this position.

ASCO Tumor Board: Neuroendocrine Tumors

This links to a forum NEC aimed mainly at doctors about standard of care options and evaluation benefits and limitations of recent treatment options including local and systemic therapies for NETs.

Announce further results on chemosaturation in liver mNET cases at European Multidisciplinary Cancer Congress
This is a further explanation of the presentation at CIRSE earlier in the month on the use of chemosaturation in cases like Jane’s. The material is dense, but many laypeople will be able to follow the basic explanation. Doctors should have no problem with this follow-up. The earlier article is posted below.

This connects to the abstract of an article in the October 1 issue of Cancer. to see the full text you will have to be a subsciber or pay a fee to see the full text.

http://medicalxpress.com/news/2011-09-benefits-radionuclide-therapy-neuroendocrine-tumors.html

This links to a summary of Dutch research into PRRT and its effects on quality of life. The original article appeared in the Journal of Nuclear Medicine  which is listed below, but this summary is more readable and available without paying the fee for the full text.

http://archsurg.ama-assn.org/cgi/content/short/146/8/953

This article from the Archives of Surgery reviews cases of liver transplants  in NEC cases. It cites a five year survival rate of 49 percent for the procedure. The article also makes suggestions about timing of the operation.

http://www.icts.uiowa.edu/content/identification-new-molecular-targets-neuroendocrine-tumors

This connects to the abstract of a study done at the University of Iowa on identifying new targets in neuroendocrine tumors. Much of this goes right over my head, but may be of use to medical researchers.

www.cancernetwork.com/gastrointestinal-cancer/content/article/10165/1921838

www.cancernetwork.com/gastrointestinal-cancer/content/article/10165/1921828

Oncology featured a pair of articles on neuroendocrine cancers in its most recent issue. The links above will take you to them. Be forewarned, they are fairly dense as they were written for the medical community.

www.nature.com/nrendo/journal/vaop/ncurrent/full/nrendo.2011.120.html

This link is to another fairly technical article in Nature Review Endocrinology. Only the abstract is linked here. To access the full text you will have to pay a fee or gain access through a site license. For laypeople that is probably not worthwhile. For those in the medical profession it likely is.

Patient-Specific Radiation Dosimetry of 99mTc-HYNIC-Tyr3 

The Journal of Nuclear Medicine has an article on dosing with a specific dye in detecting neuroendocrine tumors. This link will connect you to the abstract. The piece is highly technical–and not of much use to laypeople. For medical professionals with an interest, the full text requires a $15 payment or a subscription to the Journal.

http://www.marketwatch.com/story/positive-phase-2-trial-results-from-neuroendocrine-tumor-cohort-presented-at-cirse-2011-09-12

This is a fairly technical PR piece about a new method of dealing with neuroendocrine cancer after it metastasizes to the liver–the situation Jane was in when she was diagnosed.

http://jnm.snmjournals.org/content/52/9/1412.abstract?sid=d38bab46-ab11-47be-a18c-7ffa394ee8a6

This is the abstract to a longer article in the Journal of Nuclear Medicine on a new technique for identifying neuroendocrine tumors using antagonist rather than agonist materials. The abstract is highly technical–more aimed at radiologists than laypeople. The full text requires a subscription to the journal or the payment of a fee.

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