Endocrine Abstracts

Background: Patients with small bowel neuroendocrine tumors (SBNETs) frequently present with metastatic disease, and unfortunately, the range and efficacy of available therapies is limited. Immunotherapeutic checkpoint inhibitors have demonstrated benefit in other malignancies and may also play a role in SBNETs, although relatively little is known about the immune infiltrate in these tumors. Toward a goal of developing novel immunomodulatory strategies, we sought to evaluate t...

Background: Multiple studies have shown that approximately 50-70% of patients with MEN1 die of causes directly related to MEN1 particularly gastroenteropancreatic (GEP) neuroendocrine tumors (NETs). While non-functional GEP-NETs are the most common in the general population, gastrinomas (40%) are the most common functional GEP-NETs in patients with MEN1. c-Met is a proto-oncogene that encodes for c-MET, a tyrosine kinase receptor which promotes tumor cell motility, proliferati...

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...

Background: Somatostatin analogues (SSAs) are first-line standard of care therapies for gastroenteropancreatic neuroendocrine tumors (GEP-NET), showing efficacy in tumor/symptom control with an established safety profile. Yet, disease progression may occur despite standard-dose SSA treatment, requiring more aggressive and toxic therapies. Retrospective/non-randomized data suggest higher-dose SSAs may benefit patients with GEP-NET who do not respond to standard-dose treatment a...

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-...

Background: Combination peptide receptor radionuclide therapy (PRRT) with the multikinase inhibitor cabozantinib may result in enhanced tumor response and improved intratumoral delivery of Lu-177 DOTATATE by normalization of tumor vasculature through VEGFR inhibition.Methods: In a phase Ib trial, patients with advanced somatostatin receptor (SSTR) positive, G1-3 neuroendocrine tumors (NETs) with a Krenning score of >2 are treated with 4 x 8 week cycl...

Background: Appendiceal GCA is a tumor which has been misunderstood for decades. GCAs are comprised of goblet-like mucinous cells, with variable numbers of neuroendocrine and Paneth-like cells and lie on the spectrum between appendiceal adenocarcinoma and neuroendocrine tumors. Prognosis depends on the stage and tumor grade; 30% of patients with low-grade and 50-70% of high grade GCAs present with metastatic disease. Currently, there are limited systemic therapy options and de...

Background: The likelihood of developing a fragility fracture rises with age. Osteoarthritis, osteoporosis, and hypovitaminosis D are all extremely common diseases, with 50% of women and 20% of men experiencing a fragility fracture at some point in their lives.Objectives: First, compare the occurrence of osteoporosis, fragility fractures, and risk factors such as low vitamin D levels, low bone mineral density, and the presence of other illnesses that pre...

Case History: A 16 yr old patient presented to us concerned about her short statue. Her father and mother were at the 9th centile and her sister was at the 25th centile in adult life. She was otherwise well having gone through a normal puberty in her early teens and was currently on the oral contraceptive pill having regular periods. On examination she did display some features of Turner’s syndrome; short stature, short neck and cubitus valgus deformity. Cytogenetic analy...

Background: Glutamic acid decarboxylase 65-kilodalton isoform (GAD65) antibody is a known to be present in inhibitory interneurons and pancreatic islet β-cells. Arino et al suggests that high levels of GAD65 present with neurological symptoms should prompt physicians to screen patients for occult cancer. The literature also suggests high GAD65 antibodies have been associated with various malignancies; although large studies are lacking. This research focuses on i...