Endocrine Abstracts

Background: Immunotherapy is currently being explored in many tumour types with encouraging results, but has not yet been evaluated in neuroendocrine tumours (NET). Our aim is to characterise the immune landscape of NET and determine which immune-modulatory pathways control the tumour infiltrating lymphocytes (TILs) in order to develop a rational approach for immunotherapy in this tumour type.Methods: Peripheral blood and fresh tissue was obtained from c...

Background: Bone metastases have been described in up to 15% of patients with NETs and are associated with a worse clinical outcome. Here we investigate the role of CTCs as a marker of bone metastases in a large cohort of patients with gastroenteropancreatic NETs.Methods: To be eligible for the study, patients were required to be ≥ 18 years old, have histologically confirmed midgut or pancreatic NET (pNET) and metastatic disease measurable by RECIS...

Background: Gastrointestinal (GI) neuroendocrine tumours (NETs) are potentially malignant lesions originating from the enterochromaffin cells of the GI tract. These neoplasms often produce characteristic hormonal syndromes and can cause debilitating symptoms. Endoscopic submucosal dissection (ESD) is a well-established, complex, endoscopic technique, which allows for full resection of the mucosal and submucosal lesions without the need for open surgery.M...

Background: Although small bowel (SB) neuroendocrine tumours (SBNETs) often present as indolent lesions, late diagnosis may result in poor outcomes. Successful management is therefore dependent on early identification. Double-balloon enteroscopy (DBE) enables direct SB mucosal visualisation, sampling and endotherapy. Our aim was to evaluate the role of DBE for early diagnosis and management of SBNETs.Methods: Retrospective review of all SBNETs diagnosed/...

Background: SPINET was a phase 3 trial (NCT02683941) in patients with well-differentiated, advanced bronchopulmonary neuroendocrine tumors (NETs; typical and atypical carcinoids [TCs and ACs]). During the double-blind (DB) period, patients were randomized (2:1) to receive lanreotide autogel/depot (LAN; 120 mg) or placebo (PBO) every 28 days; in the optional open-label (OL) phase, all patients received LAN. Recruitment was stopped early due to slow accrual; all eligible patient...

Introduction: Phaeochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumours with no standardised protocol for treatment. 177Lu-DOTATATE peptide receptor radionuclide therapy (PRRT) is an emerging treatment option for patients with metastatic and/or inoperable PPGL, and with low toxicity. We present our experience with PRRT in advanced PPGL, treated in a ENETS Centre of Excellence.Materials and Methods: 165 patients with...

Neuroendocrine tumours (NETs) occur in multiple tissues and vary widely in clinical behaviour. Up to 70% of diagnosed patients have elevated circulating levels of chromogranin A, the only serum marker commonly used in clinical practice. However, its low sensitivity and the identification of confounding factors that compromise specificity have raised the need for additional or alternative markers for disease detection and management. Here we aimed to discover candidate NET mark...

Background: Type III gastric neuroendocrine neoplasms (g-NEN) are usually lesions of higher grade and often associated with loco-regional and distant metastases. Guidelines recommend partial or total gastrectomy with local lymph node resection. Data for less-extensive resections are limited.Aim: To assess whether advanced endoscopic excision [Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD)] or localized surgical approach (wed...

Introduction: Somatostatin analogues are widely used to reduce the incidence and severity of carcinoid syndrome symptoms. However, their impact on patients’ satisfaction with symptom control needs further investigation. SYMNET was a large international multicentre observation study that assessed PROs during LAN-ATG treatment of carcinoid syndrome in gastroenteropancreatic neuroendocrine tumour (GEP–NET) patients.Methods: At routine clinic visit...

Introduction: Data demonstrating antiproliferative effects of somatostatin analogs (SSAs) in enteropancreatic NETs are limited; only one prospective trial so far has shown this for patients with midgut tumors and low hepatic tumor load (HTL). CLARINET is the first large phase 3, randomized, placebo-controlled trial evaluating such effects for the SSA lanreotide in patients with non-functioning enteropancreatic NETs.Methods: Patients who had well/moderate...