Endocrine Abstracts

Background: High-grade neuroendocrine neoplasms (HG-NENs) are a heterogenous and biologically aggressive rare subset of NENs. Few therapeutic options are available to metastatic HG-NENs. To date, first line treatment is platinum- or temozolomide-based chemotherapy which provide modest benefits in overall survival (OS) and progression free survival (PFS). Given the promising activity of immunotherapy across several cancer types, our center initiated a phase II trial of pembroli...

Background: Undifferentiated pleomorphic sarcoma (UPS) of the thyroid is rare. It is often identified in its advanced stage, with distant metastasis, and has poor prognosis. This paper presents one of the less than 30 cases that have been documented ever since it was first identified in 1989. In the Philippines, there is no published report of a primary thyroid sarcoma.Case Presentation: The author describes a 73-year-ol...

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: Lu177 DOTATATE Peptide Receptor Radionucleotide Therapy (PRRT) was FDA approved in the United States in 2018, however, the data for the safety and efficacy of repeat PRRT are almost exclusively from European centers. We present an updated experience with repeat PRRT in a cohort of US patients.Methods: We used our single-center longitudinal IRB approved neuroendocrine tumor (NET) registry to identify patients who had been previously treated wi...

Background: Clinicians are concerned about increased hepatotoxicity in patients who received hepatic artery bland embolizations (TAE) and subsequent Peptide Receptor Radionuclide Therapy (PRRT). The body of literature describing the safety of PRRT following prior TAE is very limited. The purpose of this study is to evaluate the degree of long-term liver toxicity in patients who received PRRT in addition to previous hepatic embolizations for liver dominant disease.<p class=...

Background: In patients with locally advanced pancreatic neuroendocrine tumors (PNET), surgical resection is associated with improved survival. There is a paucity of data whether there is a benefit for multivisceral resection for locally advanced PNET compared to pancreatectomy alone. This study investigated the association of surgical resection on overall survival comparing pancreas specific and multivisceral resection for PNET.Methods: The Surveillance...

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: The pathogenesis, biologic behavior, and treatment of well-differentiated neuroendocrine tumors (NET) and poorly differentiated neuroendocrine carcinomas (NEC) are different. The diagnosis relies on multiple factors, but pathologic assessment is crucial. Based on currently available diagnostic criteria, the distinction between NET G3 and NEC are made on morphologic assessment, without taking Ki-67 proliferative index into consideration. This study looks at the conc...

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: Neuroendocrine tumors (NETs; ~2% of all malignancies) commonly arise from the GI tract, pancreas, and lung and often present with metastatic disease. The PI3K/Akt/mTOR pathway is implicated in the pathogenesis and progression of NETs. The oral mTOR inhibitor (mTORi), everolimus, is approved for treatment of patients with NETs of the GI tract, lung, or pancreas. However, due to the rarity and heterogeneity, nonspecific clinical symptoms, and unique indolent biology,...