Endocrine Abstracts

Background: Expected progression free survival (PFS) for patients with grade 3 well-differentiated neuroendocrine tumors (WD NET) treated with peptide receptor radionuclide therapy (PRRT) is approximately 9 months, and objective response rate (ORR) is 35%. Response rate to single agent immune checkpoint inhibitors (ICI) for patients with G1-3 NET is <15%. Delivery of targeted radiation using PRRT may potentiate the anti-tumor immune response. The purpose of this study is t...

Background: High-specific activity iodine-131 metaiodobenzylguanidine (HSA I-131 MIBG; AZEDRA®) is the only FDA approved systemic treatment for locally advanced or metastatic pheochromocytoma or paraganglioma (PPGL). We have previously described pivotal study efficacy data that served as the basis for HSA I-131 MIBG approval demonstrating improvements in blood pressure control, objective tumor responses, and biomarker responses. Here we provide the results from a European...

Background: Despite the superiority of 68Ga-DOTATATE PET/CT in the detection of neuroendocrine tumors, the clinical impact of using this imaging modality in surgical and medical oncology practices in the United States is not well established. Here we evaluate the impact of 68Ga-DOTATATE PET/CT imaging in the diagnosis and management of patients with GI and pancreatic NETs at the University of Rochester Medical Center.Methods: Single...

Background: Incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NEMs) is increasing, but etiology of sporadic, non-familial disease remains obscure. Behavioral risk factors like smoking and alcohol consumption may be associated with GEP-NENs, yet environmental factors potentially associated with GEP-NENs remain unexamined. We regressed age-adjusted incidence rates for GEP-NENs cases in California (CA) on county-level pollution data to determine if an association ...

Paltusotine is a once-daily, oral, selectively-targeted SST2 agonist in development for the treatment of acromegaly. PATHFNDR-1 (NCT04837040) enrolled patients with acromegaly who had an IGF-1 ≤1xULN on a stable (>12 weeks) dose of lanreotide or octreotide. Patients were randomized 1:1 to receive paltusotine 40 mg/day or placebo for 36 weeks. During the first 24 weeks, the paltusotine dose was titrated (range 20-60 mg) based on IGF-1 and tolerance. Dose changes were ...

Background: Patients with metastatic carcinoid disease confer a risk for carcinoid syndrome, characterized by hemodynamic instability and syncope. While the physiologic mechanisms linking carcinoid tumor metastases to impaired blood pressure regulation are not well understood, this may be attributed to changes in autonomic function, which is a key regulator of blood pressure. We hypothesize that metastatic carcinoid disease induces autonomic dysfunction. To test this, we longi...

Background: Neuroendocrine tumors that release prostaglandins and biogenic amines that can impact cardiac function. In consequence, patients with carcinoid liver metastases are at risk for carcinoid heart disease. This is primarily characterized by fibrosis in the heart that leads to plaques on the valvular cusps, leaflets and walls of the atrium and ventricles leading to a thickened right heart with regurgitation. Interestingly, 50-80% of patients with carcinoid heart disease...

Background: Well-differentiated neuroendocrine tumors (WD-NET) have a relatively low tumor mutation burden and do not commonly express the programmed death ligand 1 (PD-L1), characteristics which may limit the anti-tumor activity of PD-L1 inhibitors in this disease. Response rate to single agent immune checkpoint inhibitors (ICI) for patients with G1-3 NET is <15%. The intensity of anti-tumor immune response may be enhanced by addition of liver-directed therapy (LDT), such...

Background: Hormonally-refractory, lethal forms of PCa may express neuroendocrine features, including PCa with neuroendocrine differentiation (NEDPCa) and treatment emergent small cell neuroendocrine PCa (tSCNC). We hypothesize that some lethal metastatic PCa may show higher expression of SSTR than of PSMA and that a dual imaging approach with PET radiopharmaceuticals targeting these moieties will enable informed selection of patients for the future corresponding therapeutic r...

Background: Somatostatin receptor (SSTR) PET imaging is utilized with increasing frequency in the clinical management of neuroendocrine tumors. Incidental PET-avid CNS lesions are commonly noted and presumed to be meningiomas. However, SSTR PET lacks specificity for meningioma identification. This study aims to clarify the role of SSTR-based imaging for classification of incidental CNS lesionsMethods: Patients who had undergone both Ga-68-DOTATATE PET an...