Searchable abstracts of presentations at key conferences in endocrinology
Previous issue | Volume 98 | NANETS2023



Clinical – Chemo/SSA/Biologics

ea0098c1 | Clinical – Chemo/SSA/Biologics | NANETS2023

Clinical impact of unsuccessful subcutaneous administration of octreotide LAR instead of intramuscular administration in patients living with metastatic neuroendocrine tumors

Krishnan Tharani , Safro Maria , Moreira Furlanetto Daniel , Gill Sharlene , Paulo Solar Vasconcelos Joao , Stuart Heather C. , Martineau Patrick , Loree Jonathan M.

Background: Octreotide LAR is a long-acting somatostatin analogue used in the management of metastatic neuroendocrine tumors (NETs), with antiproliferative and symptom control effects. It requires intramuscular (IM) injection. Missed IM injections can cause subcutaneous nodules (SCNs) on radiologic images. We reviewed the rates of SCNs in a real-world cohort of NETs receiving octreotide LAR and explored treatment outcomes.Methods: Patients with gastroint...

ea0098c2 | Clinical – Chemo/SSA/Biologics | NANETS2023

Neuroendocrine tumor metastatic to breast: case report and review of the literature

Augusto Urrego Jose , Gonzalez Diaz Marcela , Ernesto Romero-Rojas Alfredo , Strosberg Jonathan , Jimenez Vasquez Paola

Background: We report a case of a patient with an ileocecal neuroendocrine tumor (NET) metastatic to both breasts, for whom the initial clinical presentation was chronic diarrhea Breast metastases were initially suspected by a 68-Gallium DOTANOC PET/CT and were confirmed by histopathology. We also performed a comprehensive (non-systematic) literature review through which we identified 116 cases of NENs metastatic to breast.Methods: Case report and compre...

ea0098c3 | Clinical – Chemo/SSA/Biologics | NANETS2023

Real-world evidence of lenvatinib use for treatment of metastatic neuroendocrine neoplasms

Paulo Solar Vasconcelos Joao , Eduardo Nunez Rodrigues Jose , Zaidi Ali , Jafari Helia , Krishnan Tharani , Gill Sharlene , Tan Ann , Le Dan , Chan Theresa , Yu Simon , Paul McGhie John , Lim Howard , Singh Simron , Michael Loree Jonathan

Background: Metastatic neuroendocrine neoplasms (NENs) constitute a heterogeneous group of uncurable cancers with limited treatment options. Lenvatinib is an oral multiple kinase inhibitor that showed activity in gastroenteropancreatic neuroendocrine tumors in the phase II Talent Trial at a starting dose of 24 mg per day. Although a confirmatory phase III study was never conducted, the drug is available for use off-label.Methods: We retrospectively revie...

ea0098c4 | Clinical – Chemo/SSA/Biologics | NANETS2023

Results from a Phase II study of nanoliposomal irinotecan (nal-IRI) with 5-fluorouracil (5-FU)/leucovorin in refractory advanced high-grade neuroendocrine cancer (HG-NEC)

Mukherjee Sarbajit , Ramirez Robert , Fountzilas Christos , Vadehra Deepak , Lynne Tarquini Mary , Attwood Kristopher , Iyer Renuka

Background: Metastatic neuroendocrine carcinomas (NECs) have a poor prognosis, and standard first-line chemotherapy combines etoposide (E) and platinum (P) has limited benefit. Currently, there is no standard second-line therapy. Irinotecan-based regimens have shown benefits; hence we explored nanoliposomal Irinotecan (nal-IRI) efficacy in this patient population.Methods: In this open-label, single-arm, multi-center Phase 2 study, advanced GEP or unknown...

ea0098c5 | Clinical – Chemo/SSA/Biologics | NANETS2023

A phase 2 clinical trial of cabozantinib in patients with unresectable and progressive metastatic pheochromocytoma or paraganglioma: The NATALIE trial

Jimenez Camilo , Habra Mouhammed A. , Campbell Matthew T. , Tamsen Gina , Cruz-Goldberg Damaris , Long James , Bassett Roland , Dantzer Robert , Balderrama Vania , Varghese Jeena , Waguespack Steven , Lu Yang

Background: Metastatic pheochromocytomas and paragangliomas are orphan neuroendocrine tumors. 50% of these tumors are associated with germline mutations of the SDHB gene. SDHB related pheochromocytomas and paragangliomas and many apparently sporadic tumors exhibit abnormal angiogenesis. This trial assessed the efficacy and safety of Cabozantinib, a potent, antiangiogenic, tyrosine kinase inhibitor. Methods: The Natalie trial is a single arm phase 2 clini...

ea0098c6 | Clinical – Chemo/SSA/Biologics | NANETS2023

The role of somatostatin analogue maintenance therapy in refractory metastatic neuroendocrine tumors (NETs): comparative analysis

Mohamed A. , Kurian M. , Patil S. , Asa S.L. , Tirumani S.H. , Mahipal A. , Bajor D. , Chakrabarti S. , Selfridge J.E. , Ocuin L.M. , Hoehn R.S. , Winter J. , Ammori J. , Hardacre J. , Henke L.E. , Bahar L.

Background: Somatostatin analogues (SSAs) are the standard of care first line therapy for metastatic well-differentiated neuroendocrine tumors (NETs). They are approved for both alleviating hormone-related symptoms for functional tumors and inhibiting tumor growth. Their anti-proliferative benefit in the refractory setting is debatable due to lack of supportive literature. This systematic review compared efficacy of targeted therapies (Everolimus, Sunitinib, Surufatinib, Lenva...

ea0098c7 | Clinical – Chemo/SSA/Biologics | NANETS2023

A phase II clinical trial of nivolumab and temozolomide for neuroendocrine neoplasms (NEN): updated overall survival data

Owen Dwight H. , Sukrithan Vineeth , Benner Brooke , Wei Lai , Goyal Ashima , Zhou Ye , Pilcher Carly , Curtis Nancy , Jukich Megan , Schwarz Emily , Savardekar Himanshu , Norman Ruthann , Ferguson Sarah , Kleiber Barbara , Wesolowski Robert , Carson William E. , Gregory A. Otterson III, , Verschraegen Claire F. , Shah Manisha H. , Konda Bhavana

Background: Treatment options are limited in patients with metastatic neuroendocrine neoplasms (NEN). Combination temozolomide and nivolumab showed encouraging objective response rates of 35.7% in advanced NEN regardless of site of origin, with response rates of 64% in lung NEN and 67% in pancreatic NEN (NCT03728361). We present updated survival data on follow-up from a phase II trial of combination nivolumab and temozolomide in patients with advanced NEN.<p class="abstext...

ea0098c8 | Clinical – Chemo/SSA/Biologics | NANETS2023

Effect of hepatic impairment on pharmacokinetics, safety, and tolerability of oral paltusotine, a small-molecule, selective somatostatin receptor subtype 2 agonist

Luo MS Rosa , Casagrande MD, PhD Alessandra , Oun BA Sonic , Wang MSPH Yang , Scott Struthers PhD R. , Usiskin MD Keith , Krasner MD Alan

Background: Paltusotine is an investigational oral, once-daily, small molecule somatostatin receptor type 2 agonist in development for the treatment of acromegaly and carcinoid syndrome associated with neuroendocrine tumors.Methods: This multicenter, open-label, phase 1 study enrolled participants with mild, moderate, and severe hepatic impairment based on Child-Pugh classification and matched healthy participants. A single 20-mg oral dose of paltusotine...

ea0098c9 | Clinical – Chemo/SSA/Biologics | NANETS2023

Anti-apoptosis as a therapeutic strategy in Neuroendocrine neoplasms (NEN): A case report

Sukrithan, MD Vineeth K. , Ahmed Uzair , Zhou Ye , Rogers MD Kerry A. , Konda, MD, MPH Bhavana

Background: The expression of BCL-2, an anti-apoptotic protein, has been implicated in the aggressive behavior of NENs. Dysregulation of BCL-2 expression, controlled by the pRb1-E2F1 axis, has been linked to the development of various cancers, including NENs. Studies have shown that higher BCL-2 expression is associated with poorer survival outcomes in NEN patients.Methods: We report a unique case of a patient with a pancreatic neuroendocrine tumor who h...

ea0098c10 | Clinical – Chemo/SSA/Biologics | NANETS2023

An ongoing phase I trial of the DLL3/CD3 IgG-like T-cell engager, BI 764532, in patients with DLL3-positive extrapulmonary neuroendocrine carcinomas

Gambardella Valentina , Capdevila Jaume , Kuboki Yasutoshi , B Alese Olatunji , Morgensztern Daniel , Sayehli Cyrus , F Sanmamed Miguel , Arriola Edurne , Wolf Jurgen , Owonikoko Taofeek , Bouzaggou Mohamed , Song Eric , Studeny Matus , Wermke Martin

Background: Delta-like ligand 3 (DLL3) is highly expressed on small-cell lung cancer (SCLC) tumors and neuroendocrine carcinomas (NECs). BI 764532 is a DLL3/CD3 IgG-like T-cell engager with potent preclinical activity. NCT04429087 is an ongoing phase I dose-escalation trial of BI 764532 in adults with locally advanced/metastatic DLL3-positive (confirmed centrally) SCLC, extrapulmonary NEC, or large cell neuroendocrine lung carcinoma. Here we focus on patients with extrapulmona...

ea0098c11 | Clinical – Chemo/SSA/Biologics | NANETS2023

Transformation of low-intermediate grade neuroendocrine tumors into high grade morphology

McGlothlin, MD John D. , Dilmaghani, MD Saam , Hazim, MD Antonious Z. , Hobday, MD Timothy J. , Sonbol, MD Mohamad B. , Starr, DO Jason S. , Eiring, PA-C Rachel A. , Graham MBBS Rondell P. , Halfdanarson, MD Thorvardur R.

Background: Low- (G1) and intermediate-grade (G2) neuroendocrine tumors (NET) are defined by lower mitotic rates and genetic mutations that rarely cause transformation to high-grade (G3) neoplasm. Yet a proportion of patients with de novo low-grade NETs progress to G3 disease or even neuroendocrine carcinoma (NEC). We aimed to highlight cases of low-grade G1 and G2 NETs that eventually transformed to G3 pathology on repeat biopsy and describe characteristics that portend high-...

ea0098c12 | Clinical – Chemo/SSA/Biologics | NANETS2023

Real world use of virtual care for treatment of gastroenteropancreatic neuroendocrine tumors (GEP-NETs)

J Phillips William , Pradier Michelle , Goodwin Rachel , Vickers Michael , Asmis Tim

Background: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a relatively rare group of tumors. Traditionally, management of unresectable GEP-NETs was performed by in-person assessment at specialized regional cancer centers. The COVID-19 pandemic resulted in an unprecedent shift towards virtual care. The aim of this study is to evaluate the use of virtual care for GEP-NETs after the COVID-19 pandemic at a high-volume academic cancer center. Me...

ea0098c13 | Clinical – Chemo/SSA/Biologics | NANETS2023

Clinical characteristics and molecular profiling of patients with pancreatic mixed acinar-neuroendocrine carcinoma

Eslinger Cody , Seddighzadeh Bobak , Elsabbagh Zaid , Pai Rish , Hartley Chris , Starr Jason , Bekaii-Saab Tanios , Halfdanarson Thorvardur , Bassam Sonbol Mohamad

Background: Pancreatic acinar cell carcinoma (PACC) is a rare cancer, comprising less than 1% of all pancreatic cancers and often presents as a mixed malignancy with a neuroendocrine component. Limited data exists on its clinical and molecular characteristics. This retrospective study aims to provide additional insights to better understand and characterize the disease.Methods: Patients from the Mayo Clinic with pathology records denoting pancreatic acin...

ea0098c14 | Clinical – Chemo/SSA/Biologics | NANETS2023

Cabozantinib as salvage therapy for well differentiated grade 3 neuroendocrine tumors (G3 NETs)

Schnell Rylie R. , Eiring Rachel A. , Miller Morgan C. , McGarrah Patrick W. , Halfdanarson Thorvardur R.

Background: G3 NETs are a recently recognized entity and although the treatment recommendations largely follow those for grade 1 and 2 NETs, the outcomes of therapy are inferior. Little is known about the optimal therapy sequencing but small studies have suggested a benefit of multikinase inhibitors. Somatostatin analogs, PRRT and chemotherapy have all been reported to have activity but later lines of therapy are needed. In this study, we sought to evaluate the activity of cab...

ea0098c15 | Clinical – Chemo/SSA/Biologics | NANETS2023

Phase II study of frontline maintenance rucaparib in combination with nivolumab in extensive stage small cell lung cancer

Chauhan Aman , Kolesar Jill , Yan Donglin , Hao Zhonglin , McGarry Ronald , Villano John , Zinner Ralph , Maskey Ashish , Miller Jordan , Mullett Timothy , Khurana Aman , Zhou Xitong , Gupta Garima , Flora Daniel , Darnell Colleen , O'Neil Richard , Kunos Charles , Anthony Lowell , Arnold Susanne

Background: Immune checkpoint inhibitor (ICI) maintenance therapy is the standard of care for frontline management of extensive-stage small cell lung cancer (ES SCLC). However, the overall survival benefit of the addition of ICI maintenance to frontline ES SCLC treatment is modest and further improvement is needed. We hypothesized that the addition of poly (ADP-ribose) polymerase inhibition to ICI maintenance therapy for patients with platinum-sensitive ES SCLC could improve t...

ea0098c16 | Clinical – Chemo/SSA/Biologics | NANETS2023

Comparison of well-differentiated gastroenteropancreatic grade 3 neuroendocrine tumors (G3NETS): de novo and in the setting of apparent grade progression over time

Khuong Le Bryan , Paciorek Alan , Moon Farhana , Lawhn Heath Courtney , Hope Thomas , Fidelman Nicholas , Mulvey Claire , Lindsay Sheila , Zhang¬ Li , Nakakura Eric , Joseph Nancy , Bergsland Emily K.

Background: G3NETs demonstrate variable clinical behavior (Ki-67>20-100%). Treatment extrapolated from grade 1/2 (G1/2) NETs and neuroendocrine carcinomas depending on clinicopathologic features. Therapy for treatment-emergent G3NETs remains especially ill-defined.Methods: Retrospective chart review of patients with de novo G3NETs or progressing from low-to-high grade (L-H) (G1/2 at diagnosis and G3 >=3 months later). Treatment patterns compared ...

ea0098c17 | Clinical – Chemo/SSA/Biologics | NANETS2023

Argentinian registry of gastric neuroendocrine tumors: A closer look at type 1

Oviedo Ana , Luca Romina , Bestani Claudia , Rodriguez Andres , Waisberg Federico , Ypa Carla , Catani Greta , Acosta Andrea , Maquieira Julian , Pombo Teresa , Kujaruk Mirta , Mendez Guillermo , O'Connor Juan

Background: Gastric neuroendocrine tumors (gNETs) are relatively uncommon. Represent up to 23% of all digestive neuroendocrine neoplasms. The majority are incidentally diagnosed from histology of ‘simple’ gastric polyps identified at endoscopy. There are 3 groups of gNETs: types 1, 2 and 3 with different pathogeneses, biological and clinical behaviors. It is worth mentioning that recent reports suggest a fourth type of gNETs1. Type I represents 75–80%...