Endocrine Abstracts

Background: Neuroendocrine tumors (NETs) are classified as functional or non-functional based on the presence of characteristic symptoms, related to tumoral secretion of biologically active peptides or amines. Carcinoid Syndrome (CS) is the commonest functional NET syndrome, seen at diagnosis in 19% of patients. It is characterized in over 80% of cases by watery diarrhea (mainly due to serotonin hypersecretion) or cutaneous flushing. Somatostatin is a neuropeptide that inhibit...

It is well known that there exists a correlative relationship between diabetes mellitus (DM) and sex hormone levels. However, it has not yet been found if it is caused either by hyperinsulinemia, or hyperglycemia or insulin resistance (IR). Eighty-one men with DM and 35 healthy men with normal glucose levels were examined. In each group the persons were divided into four age subgroups: 36–45 years old, 46–55, 56–65 and 66–75 years old. IR was estimated usin...

Background: A small portion (11%) of radioactive decay of 177Lu involves the emission of gamma photons, allowing for post-treatment imaging. Despite this capability, most centers do not routinely conduct post-treatment imaging. It is not well recognized that qualitative findings from post-PRRT imaging can influence clinical management. The aim of this study was to evaluate the rate of change in management from post treatment imaging.Methods: 100 patients...

Background: Preoperative grading of pancreatic neuroendocrine tumors (PNET) incorporating Ki-67 index can identify PNETs at low risk of progression and prevent unnecessary surgical resection. The aim of this study was to perform a comprehensive literature search and meta-analysis to compare the accuracy of Ki-67 based grading of PNETs between endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) vs fine needle biopsy (FNB).Methods: Literature s...

Background: Immune checkpoint inhibitors have not been shown to be active in well-differentiated NETs, with response rates <5%. Lenvatinib is a multitargeted TKI which targets VEGF and FGF receptors and has been reported to be effective in pancreatic and gastrointestinal NETs (40% and 18.5% ORR, respectively). The combination of antiangiogenic and checkpoint inhibitor therapies can be synergistic in other cancers. We therefore evaluated the combination of lenvatinib and pe...

Background: Pancreatic neuroendocrine neoplasms rarely secrete ACTH resulting in ectopic Cushing’s syndrome. Data are limited to case reports and very small series.Methods: Cases of ectopic Cushing’s syndrome were identified from a database of pancreatic NEN seen at the Moffitt Cancer Center between 1/2008 and 4/2022. Tumor characteristics, clinical signs and symptoms, therapies and outcomes were evaluated.Results: 13 pat...

Background: Somatostatin receptor (SSTR) expression in metastatic lung neuroendocrine (carcinoid) tumors has not been well-characterized using modern positron emission tomography (PET) imaging. Understanding degree and uniformity of SSTR expression is important to establish the role of SSTR targeted treatments, including peptide receptor radiotherapy (PRRT), in lung NETs.Methods: Retrospective review of medical records and imaging studies of patients wit...

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...

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: 177Lutetium (Lu)-Dotatate is a safe and well tolerated treatment for metastatic gastroenteropancreatic (GEP) NETs. However, radiation can cause transient inflammation/swelling of tumors which can result in toxicity. Treatment-related small bowel obstruction associated with mesenteric or peritoneal disease has been described. We investigated the potential for intestinal ischemia in 177Lu-Dotatate treated patients.Methods:...