NET εντέρου Τι νεότερο/ Νέες μελέτες. Μαντώ Νικολαΐδη παθολόγος-ογκολόγος ΜΗΤΕΡΑ

Size: px
Start display at page:

Download "NET εντέρου Τι νεότερο/ Νέες μελέτες. Μαντώ Νικολαΐδη παθολόγος-ογκολόγος ΜΗΤΕΡΑ"

Transcription

1 NET εντέρου Τι νεότερο/ Νέες μελέτες Μαντώ Νικολαΐδη παθολόγος-ογκολόγος ΜΗΤΕΡΑ

2 NET: A Diverse Group of Malignancies 1-3 Wide spectrum of malignancies arising in neuroendocrine cells throughout the body 1 pnet (formerly called islet cell tumors) Functional a (<10%) 4 Gastrinoma Insulinoma Glucagonoma VIPoma Somatostatinoma Pancreatic polypeptidoma Nonfunctional a (<90%) 4 a A consensus definition of functional vs nonfunctional pnet does not exist. 5 Estimates of frequency vary widely. Other NET (also referred to as carcinoid tumors) Foregut Lung Stomach Duodenum Thymus Midgut Jejunum Ileum Transverse, right colon Appendix Hindgut Left, sigmoid colon Rectum Additional sites Ovary Medullary thyroid carcinoma Adrenal medulla Paraganglia 1. Yao JC et al. J Clin Oncol. 2008;26: NCCN Clinical Practice Guidelines in Oncology. Neuroendocrine Tumors. Version Available at: Accessed January, Ramage JK et al. Gut. 2005;54(suppl IV):iv1- iv Pavel M et al. Neuroendocrinology. 2016;103: Halfdanarson TR et al. Endocr Relat Cancer. 2008;15: NCCN, National Comprehensive Cancer Network; NET, neuroendocrine tumors; pnet, pancreatic neuroendocrine tumors; VIPoma, vasoactive intestinal polypeptide-secreting tumors.

3 Broad range of treatment options for NET 1,2,3 Surgery Resection of primary tumor Cytoreductive surgery of unresectable tumor Curative (rarely), ablative (very often) Medical therapy Somatostatin analogs (SSAs) Interferon-alfa Targeted therapies mtor inhibitors VEGFR inhibitors other TKIs Chemotherapy Debulking / locoregional therapy Radiofrequency ablation (RFA) Embolization / chemoembolization / radioembolization Nuclear medicine and irradiation Tumor-targeted, radioactive therapy: PRRT using e.g. MIBG 90 Y-DOTATOC 177 Lu-DOTATATE External irradiation (for bone-, brainmetastases) Brachytherapy (for liver metastases) Personalized treatment required 1. ENETS consensus guidelines for the management of NET. 2. Neuroendocrinology. 2012;95: NCCN Clinical Practice Guidelines in Oncology. Neuroendocrine Tumors. Version Available at: Accessed January, MIBG, meta iodobenzylguanidine; mtor, mammalian target of rapamycin; PRRT, peptide-receptor radiotherapy; TKI, tyrosine kinase inhibitor; VEGFR, vascular endothelial growth factor receptor.

4 RANDOMIZATION (1:1) PROMID: Evaluation of the antiproliferative effect of octreotide LAR Phase III randomized, double-blind, placebo-controlled study Primary endpoint: TTP: Time to Tumor Progression (blinded central review) Secondary endpoints: objective response rate, OS, quality of life, safety Patients with midgut NETs Treatment-naïve Histologically confirmed Locally inoperable or metastatic Well-differentiated Measurable (CT/MRI) Functioning or nonfunctioning Octreotide LAR 30 mg im every 28 days (42 pts) Placebo im every 28 days (43 pts) Treatment until CT/MRI documented tumour progression or death Month Rinke et al. J Clin Oncol. 2009; 27:

5 PROMID: Octreotide LAR 30 mg significantly extends TTP compared to placebo 66% reduction in the risk of tumor progression 1 HR=0.34; 95% CI: ; P= TTP, time to progression; HR, hazard ratio; CI, confidence interval. 1. Rinke A et al. J Clin Oncol. 2009; 27: Reprinted with permission of Journal of Clinical Oncology.

6

7

8

9

10

11

12

13

14

15 RADIANT-2: Everolimus and Octreotide LAR Combination Therapy Patients with advanced NET and a history of secretory symptoms (N = 429; pnet, n = 26) Advanced low- or intermediate-grade NET Measurable disease per RECIST 1.0 Radiologic progression 12 months History of secretory symptoms (flushing, diarrhea) Prior antitumor therapy allowed R A N D O M I Z E 1:1 Everolimus 10 mg/day + octreotide LAR depot 30 mg/28 days n = 216 Crossover at time of disease progression Placebo + octreotide LAR depot 30 mg/28 days n = 213 Treatment until disease progression WHO PS 2 Multiphasic CT or MRI performed every 12 weeks Primary end points PFS (RECIST 1.0) by central review Secondary end points Tumor response, OS, biomarkers, safety, PK Pavel ME et al. Lancet. 2011;378:

16 RADIANT-2: Baseline Demographics & Disease Characteristics Imbalances in favor of placebo plus octreotide LAR arm Everolimus + Octreotide LAR n = 216 Placebo + Octreotide LAR n = 213 Median age, years (range) 60 (22-83) 60 (27-81) Male/female sex, n (%) 97(45)/ 119 (55) 124 (58)/ 89 (42) WHO PS, n (%) (55) 140 (66) 1 / 2 84 (39)/ 14 (6) 62 (29)/ 10 (5) Primary site of cancer Small intestine 111 (51) 113 (53) Lung 33 (15) 11 (5) Colon 14 (6) 14 (7) Pancreas 11 (5) 15 (7) Liver 7 (3) 11 (5) Other/ Missing 40 (19)/ 0 (0) 48 (23)/ 1 (0.5) *Data missing for one patent in the placebo-octreotide LAR group. Pavel M, et al. Lancet. 2011;378(9808):

17 RADIANT-2 subgroups: PFS per Central Radiology Review in Patients with Primary Colorectal NET Colorectal NET 1 1. Castellano D et al. The Oncologist. 2013;18:46 53; 2. Fazio N, et al. Chest. 2013;143:955-62

18 RADIANT-4 Study Design 1 Patients with welldifferentiated (G1/G2), advanced, progressive, nonfunctional NET of lung or GI origin (N = 302) Absence of active or any history of carcinoid syndrome Pathologically confirmed advanced disease R A N D O M I Z E 2:1 Everolimus 10 mg/day N = 205 Placebo N = 97 Treated until PD, intolerable AE, or consent withdrawal Enrolled within 6 months from radiologic progression Endpoints: Primary: PFS (central) Key Secondary: OS Secondary: ORR, DCR, safety, HRQoL (FACT-G), WHO PS, NSE/CgA, PK Stratified by: Prior SSA treatment (yes vs. no) Tumor origin (stratum A vs. B)* WHO PS (0 vs. 1) *Based on prognostic level, grouped as: Stratum A (better prognosis) appendix, caecum, jejunum, ileum, duodenum, and NET of unknown primary. Stratum B (worse prognosis) lung, stomach, rectum, and colon except caecum. Crossover to open label everolimus after progression in the placebo arm was not allowed prior to the primary analysis. 1. Yao JC et al. Lancet. 2016;387:

19 Probability of Progression-free Survival (%) RADIANT-4: PFS by Central Review Primary Endpoint 52% reduction in the relative risk of progression or death with everolimus vs placebo HR = 0.48 (95% CI, ); P < Kaplan-Meier medians Everolimus: 11.0 months (95% CI, ) Placebo: 3.9 months (95% CI, ) Everolimus Placebo Censoring Times Everolimus (n/n = 113/205) Placebo (n/n = 65/97) No.of patients still at risk Months P-value is obtained from the stratified one-sided log-rank test; Hazard ratio is obtained from stratified Cox model. 1. Yao JC et al. Lancet. 2016;387:

20 RADIANT-4: Consistent PFS HR by Stratification Factors Central Review Subgroups No. Hazard Ratio (95% CI) Prior SSA treatment Yes No Tumor origin* Stratum A Stratum B WHO PS ( ) 0.60 ( ) 0.63 ( ) 0.43 ( ) 0.58 ( ) 0.50 ( ) Everolimus Better Placebo Better *Based on prognostic level, grouped as: Stratum A (better prognosis) - appendix, caecum, jejunum, ileum, duodenum, and NET of unknown primary). Stratum B (worse prognosis) - lung, stomach, rectum, and colon except caecum). Hazard ratio obtained from unstratified Cox model. NET, neuroendocrine tumors; SSA, somatostatin analogues; WHO PS, World Health Organization performance status. 1. Yao JC et al. Lancet. 2016;387:

21 Primary tumor origin RADIANT-4: PFS Treatment Effect by Primary Tumor Per Central Review PFS events Hazard Ratio [95% CI] Everolimus n/n (%) Placebo n/n (%) Lung (N=90) 0.50 [ ] 42/63 (66.7) 18/27 (66.7) Stomach (N=11) 0.31 [ ] 3/7 (42.9) 4/4 (100) Rectum (N=40) 0.17 [ ] 21/25 (84.0) 14/15 (93.3) Ileum (N=71) 1.34 [ ] 22/47 (46.8) 11/24 (45.8) Jejunum (N=22) CUP (N=36) Other (N=32) Everolimus Placebo 4 5 In favor of All hazard ratios presented for these subgroup analyses were unstratified and unadjusted for any covariates [ ] 0.60 [ ] 0.38 [ ] 5/16 (31.3) 11/23 (47.8) 9/24 (37.5) 5/6 (83.3) 8/13 (61.5) 5/8 (62.5) Everolimus demonstrated a consistent positive treatment effect across multiple primary tumor locations In the ileum subgroup only 22 progression events were reported out of 47 patients in the everolimus arm vs 11 out of 24 patients in the placebo arm The better prognosis for the ileum subgroup in relation to the median duration of follow-up may have been insufficient to demonstrate the potential benefit of treatment 1. Singh S et al European Neuroendocrine Tumor Society (ENETS), Barcelona, Spain. Abstract L20 26

22 Probability of progression-free survival (%) Probability of progression-free survival (%) Everolimus Placebo RADIANT-4 subgroups: PFS HR by Primary tumor origin GI-NET and Unknown Primary (Central Review) Everolimus improved median PFS in both the GI and unknown primary subgroups GI Subgroup Kaplan-Meier medians Everolimus: months (95% CI, ) Placebo: 5.36 months (95% CI, ) HR (95% CI): 0.56 (0.37; 0.84) 1 Censoring Times Everolimus (n/n = 59/118) Placebo (n/n = 39/57) Time (Months) No. of patients still at risk Everolimus Placebo Unknown Primary Subgroup Kaplan-Meier medians Everolimus: months (95% CI, 4.14-NA) Placebo: 7.52 months (95% CI, ) HR (95% CI): 0.60 (0.24; 1.51) 1 Censoring Times Everolimus (n/n = 11/23) Placebo (n/n = 8/13) Time (Months) No. of patients still at risk This is a retrospective post-hoc analysis. Stomach, colon, rectum, appendix, caecum, ileum, duodenum, and jejunum are grouped under GI subgroup. The HRs in both subgroups are obtained from an unstratified Cox model. CI, confidence interval; GI, gastrointestinal; HR, hazard ratio; NET, neuroendocrine tumors; PFS, progression free survival 1. Singh S et al. Presented at ENETS 2016; Abstract L20.

23 NETTER 1: Phase III Study of 177 Lu-DOTATATE + Octreotide vs. High-Dose Octreotide in Advanced Midgut NET Study design Treatment and Assessments Tumor burden assessment (RECIST, v1.1 criteria) every 12 weeks Dose 1 Dose 2 Dose 3 Dose 4 Patients with inoperable, SSR positive, WD midgut NET progressive under octreotide LAR 30 mg n = 115 n = administrations of 7.4 GBq of 177 Lu-Dotatate every 8 weeks + octreotide LAR 30 mg Octreotide LAR 60 mg every 4 weeks 5 years of followup after LPFV Primary endpoint: PFS Secondary endpoints: ORR, OS, safety, safety profile and QoL Stratification: According to a. the highest tumor uptake score on somatostatin receptor scintigraphy, b. the length of time that a patient had been receiving a constant dose of octreotide ( 6 months or >6 months). RECIST, Response Evaluation Criteria in Solid Tumors, LAR, long-acting release; RECIST, response evaluation criteria in solid tumours; SSR, somatostatin receptor; WD, well differentiated; LPFV, Last Patient First Visit 1. Strosberg J et al. N Engl J Med. 2017;376:125-35

24

25 PFS probability (%) NETTER-1: PFS in Midgut NET Kaplan-Meier medians 177 Lu-Dotatate + long-acting octreotide 30 mg a : not reached Long-acting octreotide 60 mg: 8.4 months Lu-Dotatate + long-acting octreotide 30 mg a Long-acting octreotide 60 mg Time (months) a Received 177 Lu-Dotatate at a dose of 7.4 GBq every 8 weeks (4 intravenous infusions plus best supportive care, including 30 mg long-acting octreotide). Figure from N Engl J Med. Strosberg J et al. Phase 3 Trial of 177 Lu-Dotatate for Midgut Neuroendocrine Tumors. 376: Copyright 2017 Massachusetts Medical Society. Reprinted with permission from Massachusetts Medical Society. 30

26 NETTER-1: Safety Profile (1/2) Treatment-emergent AEs in 20% of patients treated with 177Lu- Dotatate (vs control [long-acting octreotide 60 mg]) Lu-Dotatate (n = 111) All Grades, % Grade 3/4, % Mean leukocyte, lymphocyte, platelet and neutrophil count decreased from baseline in patients treated with 177 Lu-Dotatate Octreotide LAR 60 mg (n = 110) All Grades, % Grade 3/4, % Nausea Vomiting Fatigue/asthenia Abdominal pain Diarrhea Musculoskeletal pain Strosberg J et al. N Engl J Med. 2017;376:

27 NETTER-1: QOL Global Health Status Treatment with 177 Lu-Dotatate is associated with improvement in QOL in QLQ-C30 Global Health Status No evidence of significantly decreased QOL with 177 Lu-Dotatate observed in any domain 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Oct Lu Week 12 Worsened No change Improved Oct Lu Oct Lu Oct Lu Oct Lu Oct Lu Week Week a 36 Week Week 48 a 60 Week 72 Lu, 177 Lu-Dotatate; Oct, octreotide; QLQ-C30, European Organization for Research and Treatment of Cancer quality of life questionnaire core 30. a Statistically significant difference between the arms at weeks 24 and 48. Figure reproduced with permission from Strosberg J et al. Presented at: 14th Annual European Neuroendocrine Tumor Society 2017 Conference; March 8-10, 2017; Barcelona, Spain. 32

28 Objective To provide additional OLE data on the effect of telotristat ethyl, compared with placebo, on the incidence of treatment-emergent adverse events (TEAEs) and on u5-hiaa levels. Methods Study treatment and design Telotristat Etiprate for Carcinoid Syndrome Therapy (TELECAST) is a Phase 3, randomized, multicenter, parallel-group, double-blind, placebo-controlled study (ClinicalTrials.gov identifier: NCT , Figure 1). Efficacy and safety assessments Primary safety and efficacy endpoints were the incidence of TEAEs and percentage change from Baseline in 24-hour u5-hiaa levels at Week 12.3

29

30

31

32

TRACTAMENT ONCOLÒGIC DELS TUMORS NEUROENDOCRINS METASTÀSICS

TRACTAMENT ONCOLÒGIC DELS TUMORS NEUROENDOCRINS METASTÀSICS TRACTAMENT ONCOLÒGIC DELS TUMORS NEUROENDOCRINS METASTÀSICS Jaume Capdevila Unitat de Tumors GI i Endocrins Hospital Universitari Vall d Hebron Barcelona Experts, acollidors i solidaris OUTLINE BACKGROUND

More information

Nuevas alternativas en el manejo de TNE avanzados

Nuevas alternativas en el manejo de TNE avanzados Nuevas alternativas en el manejo de TNE avanzados Jaume Capdevila Hospital Universitari Vall d Hebron Barcelona Coordinación científica: Dr. Fernando Rivera Hospital Universitario Marqués de Valdecilla,

More information

MEDICAL MANAGEMENT OF METASTATIC GEP-NET

MEDICAL MANAGEMENT OF METASTATIC GEP-NET MEDICAL MANAGEMENT OF METASTATIC GEP-NET Jeremy Kortmansky, MD Associate Professor of Clinical Medicine Yale Cancer Center DISCLOSURES: NONE Introduction Gastrointestinal and pancreatic neuroendocrine

More information

Selection of Appropriate Treatment

Selection of Appropriate Treatment Expert Review in Metastatic Gastroenteropancreatic Neuroendocrine Tumors (GEP-NETs): Selection of Appropriate Treatment Reference Slide Deck Neuroendocrine Tumors (NETs): A Diverse Group of Malignancies

More information

Cutting Edge Treatment of Neuroendocrine Tumors

Cutting Edge Treatment of Neuroendocrine Tumors Cutting Edge Treatment of Neuroendocrine Tumors Daneng Li, MD Assistant Clinical Professor Department of Medical Oncology & Therapeutics Research City of Hope Click to edit Master Presentation Date DISCLOSURE

More information

Cutting Edge Treatment of Neuroendocrine Tumors

Cutting Edge Treatment of Neuroendocrine Tumors Cutting Edge Treatment of Neuroendocrine Tumors Daneng Li, MD Assistant Clinical Professor Department of Medical Oncology & Therapeutics Research City of Hope Click to edit Master Presentation Date DISCLOSURE

More information

OPTIMISING OUTCOMES IN GASTROINTESTINAL NEUROENDOCRINE TUMOURS

OPTIMISING OUTCOMES IN GASTROINTESTINAL NEUROENDOCRINE TUMOURS OPTIMISING OUTCOMES IN GASTROINTESTINAL NEUROENDOCRINE TUMOURS Dr Mairéad McNamara Senior lecturer, University of Manchester & Honorary Consultant in Medical Oncology, The Christie NHS Foundation Trust

More information

Review of Gastrointestinal Carcinoid Tumors: Latest Therapies

Review of Gastrointestinal Carcinoid Tumors: Latest Therapies Review of Gastrointestinal Carcinoid Tumors: Latest Therapies Arvind Dasari, MD, MS Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston, TX, USA Neuroendocrine

More information

Gastrointestinal Neuroendocrine Tumors: A Closer Look at the Characteristics of These Diverse Tumors

Gastrointestinal Neuroendocrine Tumors: A Closer Look at the Characteristics of These Diverse Tumors Gastrointestinal Neuroendocrine Tumors: A Closer Look at the Characteristics of These Diverse Tumors Jaume Capdevila, MD, PhD Vall d'hebron University Hospital Vall d'hebron Institute of Oncology (VHIO)

More information

NET ΠΝΕΥΜΟΝΑ: τι νεότερο / νέες μελέτες

NET ΠΝΕΥΜΟΝΑ: τι νεότερο / νέες μελέτες NETMASTERCLASS 2017: an interactive workshop NET ΠΝΕΥΜΟΝΑ: τι νεότερο / νέες μελέτες Νικόλαος Τσουκαλάς MD, MSc, PhD Ογκολόγος - Παθολόγος, MSc Βιοπληροφορική Επιμελητής Α, Ογκολογικό Τμήμα Νοσηλευτικό

More information

Evaluation and Management of Neuroendocrine Tumors

Evaluation and Management of Neuroendocrine Tumors Evaluation and Management of Neuroendocrine Tumors Jennifer Chan, MD, MPH Clinical Director, Program in Neuroendocrine and Carcinoid Tumors Dana-Farber/Brigham and Women's Cancer Center October 14, 2017

More information

NET und NEC. Endoscopic and oncologic therapy

NET und NEC. Endoscopic and oncologic therapy NET und NEC Endoscopic and oncologic therapy Classification well-differentiated NET - G1 and G2 - carcinoid poorly-differentiated NEC - G3 - like SCLC well differentiated NET G3 -> elevated proliferation

More information

EXOCRINE: 93% Acinar Cells Duct Cells. ENDOCRINE: 5% Alpha Cells Beta Cells Delta Cells Others

EXOCRINE: 93% Acinar Cells Duct Cells. ENDOCRINE: 5% Alpha Cells Beta Cells Delta Cells Others EXOCRINE: 93% Acinar Cells Duct Cells Digestive Enzymes Trypsin: Digests Proteins Lipases: Digests Fats Amylase: Digest Carbohydrates ENDOCRINE: 5% Alpha Cells Beta Cells Delta Cells Others Hormones Glucagon

More information

Jaume Capdevila, MD GI and Endocrine Tumor Unit Vall d Hebron University Hospital Developmental Therapeutics Unit Vall d Hebron Institute of Oncology

Jaume Capdevila, MD GI and Endocrine Tumor Unit Vall d Hebron University Hospital Developmental Therapeutics Unit Vall d Hebron Institute of Oncology Jaume Capdevila, MD GI and Endocrine Tumor Unit Vall d Hebron University Hospital Developmental Therapeutics Unit Vall d Hebron Institute of Oncology OUTLINE Molecular Rationale for the use of SSAs in

More information

QOL Improvements in NETTER-1 Phase III Trial in Patients With Progressive Midgut Neuroendocrine Tumors

QOL Improvements in NETTER-1 Phase III Trial in Patients With Progressive Midgut Neuroendocrine Tumors QOL Improvements in NETTER-1 Phase III Trial in Patients With Progressive Midgut Neuroendocrine Tumors Abstract C-33 Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, Baum RP, Kunz P, Hobday

More information

Toward More Aggressive Management of Neuroendocrine Tumors: Current and Future Perspectives

Toward More Aggressive Management of Neuroendocrine Tumors: Current and Future Perspectives Toward More Aggressive Management of Neuroendocrine Tumors: Current and Future Perspectives Moderator: Ashley Grossman, MD, FRCP Professor of Neuroendocrinology William Harvey Research Institute Barts

More information

Le target therapy nei Tumori Neuroendocrini

Le target therapy nei Tumori Neuroendocrini Le target therapy nei Tumori Neuroendocrini Take home messages Franco Grimaldi SOC Endocrinologia e Malattie del Metabolismo Nutrizione Clinica Azienda Ospedaliero-Universitaria Santa Maria della Misericordia

More information

Hot of the press. Γρηγόριος Καλτσάς MD FRCP Καθηγητής Παθολογίας Ενδοκρινολογίας ΕΚΠΑ

Hot of the press. Γρηγόριος Καλτσάς MD FRCP Καθηγητής Παθολογίας Ενδοκρινολογίας ΕΚΠΑ Hot of the press Γρηγόριος Καλτσάς MD FRCP Καθηγητής Παθολογίας Ενδοκρινολογίας ΕΚΠΑ Outline Diagnostic developments Histopathology Molecular Therapeutic developments Results on PRRT Telotristat in carcinoid

More information

Background. Capdevila J, et al. Ann Oncol. 2018;29(Suppl 8): Abstract 1307O. 1. Dasari A, et al. JAMA Oncol. 2017;3(10):

Background. Capdevila J, et al. Ann Oncol. 2018;29(Suppl 8): Abstract 1307O. 1. Dasari A, et al. JAMA Oncol. 2017;3(10): Efficacy of Lenvatinib in Patients With Advanced Pancreatic (pannets) and Gastrointestinal (ginets) WHO Grade 1/2 (G1/G2) Neuroendocrine Tumors: Results of the International Phase II TALENT Trial (GETNE

More information

Teresa Alonso Gordoa Servicio Oncología Médica Hospital Universitario Ramón y Cajal

Teresa Alonso Gordoa Servicio Oncología Médica Hospital Universitario Ramón y Cajal Teresa Alonso Gordoa Servicio Oncología Médica Hospital Universitario Ramón y Cajal Incidence per 100,000 EPIDEMIOLOGY Incidence rates of neuroendocrine tumors by primary tumor site 1.4 1.2 1.0 0.8 0.6

More information

Recent developments of oncology in neuroendocrine tumors (NETs)

Recent developments of oncology in neuroendocrine tumors (NETs) Recent developments of oncology in neuroendocrine tumors (NETs) Marc Peeters MD, PhD Coordinator Multidisciplinary Oncological Center Antwerpen (MOCA) Head of the Oncology Department UZA, Professor in

More information

Prior Authorization Review Panel MCO Policy Submission

Prior Authorization Review Panel MCO Policy Submission Prior Authorization Review Panel MCO Policy Submission A separate copy of this form must accompany each policy submitted for review. Policies submitted without this form will not be considered for review.

More information

Strategies in the Management of Neuroendocrine Tumors. Dr. Jean Maroun Dr. Elena Tsvetkova

Strategies in the Management of Neuroendocrine Tumors. Dr. Jean Maroun Dr. Elena Tsvetkova Strategies in the Management of Neuroendocrine Tumors Dr. Jean Maroun Dr. Elena Tsvetkova 1 A ZORSE 2 Neuroendocrine Tumour Classification Neuroendocrine Tumours Carcinoid Tumours Pancreatic Neuroendocrine

More information

GI CARCINOID Dr Mussawar Iqbal Consultant Oncologist Hull and East Yorkshire Hospitals NHS Trust

GI CARCINOID Dr Mussawar Iqbal Consultant Oncologist Hull and East Yorkshire Hospitals NHS Trust GI CARCINOID Dr Mussawar Iqbal Consultant Oncologist Hull and East Yorkshire Hospitals NHS Trust Introduction Carcinoid was old term, introduced in 1906 by German pathologist Cancinoma like More recent

More information

Pancreatic Neuroendocrine Tumours

Pancreatic Neuroendocrine Tumours UCLH Cancer Collaborative Pancreas Update Meeting 12 th July 2017 Pancreatic Neuroendocrine Tumours Dr. Christos Toumpanakis MD PhD FRCP Consultant in Gastroenterology/Neuroendocrine Tumours Hon. Senior

More information

PNET 3/7/2015. GI and Pancreatic NETs. The Postgraduate Course in Breast and Endocrine Surgery. Decision Tree. GI and Pancreatic NETs.

PNET 3/7/2015. GI and Pancreatic NETs. The Postgraduate Course in Breast and Endocrine Surgery. Decision Tree. GI and Pancreatic NETs. GI and Pancreatic NETs The Postgraduate Course in Breast and Endocrine Surgery Disclosures Ipsen NET Advisory Board Marines Memorial Club and Hotel San Francisco, CA Eric K Nakakura San Francisco, CA March

More information

Antiangiogenics are effective treatments in NETs

Antiangiogenics are effective treatments in NETs RENET: A randomized phase III trial comparing REgorafenib to placebo in patients with advanced, progressive, well-differentiated NEuroendocrine Tumors (NETs). Coordinators: Dr Julien Hadoux & Dr David

More information

NET del pancreas ben differenziato: la terapia oncologica. Alfredo Berru: Università degli Studi di Brescia Azienda Ospedaliera Spedali Civili Brescia

NET del pancreas ben differenziato: la terapia oncologica. Alfredo Berru: Università degli Studi di Brescia Azienda Ospedaliera Spedali Civili Brescia NET del pancreas ben differenziato: la terapia oncologica Alfredo Berru: Università degli Studi di Brescia Azienda Ospedaliera Spedali Civili Brescia Systemic treatment op:ons Somatosta:n analogues Interpheron

More information

SIRT in the Management of Metastatic Neuroendocrine Tumors

SIRT in the Management of Metastatic Neuroendocrine Tumors SIRT in the Management of Metastatic Neuroendocrine Tumors Navesh K. Sharma, DO, PhD Assistant Professor, Departments of Radiation Oncology, Diagnostic Radiology and Nuclear Medicine Medical Director,

More information

Neuroendocrine Tumors: Just the Basics. George Fisher, MD PhD

Neuroendocrine Tumors: Just the Basics. George Fisher, MD PhD Neuroendocrine Tumors: Just the Basics George Fisher, MD PhD Topics that we will not discuss Some types of lung cancer: Small cell neuroendocrine lung cancer Large cell neuroendocrine lung cancer Some

More information

Neuroendocrine Tumors

Neuroendocrine Tumors Neuroendocrine Tumors Neuroendocrine tumors arise from cells that release a hormone in response to a signal from the nervous system. Neuro refers to the nervous system. Endocrine refers to the hormones.

More information

Octreotide LAR in neuroendocrine tumours a summary of the experience

Octreotide LAR in neuroendocrine tumours a summary of the experience Endocrinology in oncology Review article Octreotide LAR in neuroendocrine tumours a summary of the experience Agnieszka Kolasińska-Ćwikła, MD, PhD Department of Chemotherapy, Oncology Clinic, Maria Sklodowska-Curie

More information

GEP NET: algoritmo terapeutico. Dottor Nicola Fazio

GEP NET: algoritmo terapeutico. Dottor Nicola Fazio GEP NET: algoritmo terapeutico Dottor Nicola Fazio Basi per il trattamento Caratteristiche del paziente Caratteristiche del tumore P.S., sindrome, comorbidità Differenziazione, Ki-67 Imaging morfologico

More information

Lu 177-Dotatate (Lutathera) Therapy Information

Lu 177-Dotatate (Lutathera) Therapy Information Lu 177-Dotatate (Lutathera) Therapy Information Information for Lu 177-dotatate therapy also known as Lutathera, for the treatment of metastatic midgut neuroendocrine tumor and other metastatic neuroendocrine

More information

WHAT TO EXPECT IN 2015? - Renuka Iyer, MD Associate Professor of Medicine, University at Buffalo Associate Professor of Oncology, Roswell Park Cancer

WHAT TO EXPECT IN 2015? - Renuka Iyer, MD Associate Professor of Medicine, University at Buffalo Associate Professor of Oncology, Roswell Park Cancer WHAT TO EXPECT IN 2015? - Renuka Iyer, MD Associate Professor of Medicine, University at Buffalo Associate Professor of Oncology, Roswell Park Cancer Institute Overview Diagnosis: Gallium scan Biomarkers

More information

Management of Neuroendocrine Tumors

Management of Neuroendocrine Tumors Management of Neuroendocrine Tumors Professor Barbro Eriksson Department of Endocrine Oncology ENETS Centre of Excellence Uppsala University Hospital Diagnostic Challenges in NET Heterogeneous group of

More information

EXOCRINE: 93% Acinar Cells Duct Cells. ENDOCRINE: 5% Alpha Cells Beta Cells Delta Cells Others

EXOCRINE: 93% Acinar Cells Duct Cells. ENDOCRINE: 5% Alpha Cells Beta Cells Delta Cells Others EXOCRINE: 93% Acinar Cells Duct Cells Digestive Enzymes Trypsin: Digests Proteins Lipases: Digests Fats Amylase: Digest Carbohydrates ENDOCRINE: 5% Alpha Cells Beta Cells Delta Cells Others Hormones Glucagon

More information

Chair s presentation Lutetium (177lu) oxodotreotide for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease

Chair s presentation Lutetium (177lu) oxodotreotide for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease Public slides Chair s presentation Lutetium (177lu) oxodotreotide for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease 2 nd Appraisal Committee meeting Committee

More information

Recent Advances in Gastrointestinal Cancers

Recent Advances in Gastrointestinal Cancers Recent Advances in Gastrointestinal Cancers Ursina R. Teitelbaum, MD Section of Hematology/Oncology Abramson Cancer Center PENN 2016 Updates in Oncology June 23, 2016 none Disclosures ASCO 2016 Highlights:

More information

Development of New Treatment Modalities Oncolytic Viruses and Nanotechnique

Development of New Treatment Modalities Oncolytic Viruses and Nanotechnique Development of New Treatment Modalities Oncolytic Viruses and Nanotechnique By Professor Kjell Öberg, M.D., Ph.D. Dept. of Endocrine Oncology, University Hospital, Uppsala, Sweden Nashville Oct. 2011 Hallmarks

More information

Pancreatic NeuroEndocrine Tumors. Prof Eric Van Cutsem, MD, PhD Gastroenterology/Digestive Oncology Leuven, Belgium

Pancreatic NeuroEndocrine Tumors. Prof Eric Van Cutsem, MD, PhD Gastroenterology/Digestive Oncology Leuven, Belgium Pancreatic NeuroEndocrine Tumors Prof Eric Van Cutsem, MD, PhD Gastroenterology/Digestive Oncology Leuven, Belgium Epidemiology Overall incidence 1.8 to 2.6 SEER, Europe Peak in 5 th and 6 th decade Incidence

More information

Oberndofer 1907 Illeal Serotonin Secreting Tumor Carcinoid (Karzinoide)

Oberndofer 1907 Illeal Serotonin Secreting Tumor Carcinoid (Karzinoide) GEP-NET Adel K. El-Naggar, M.D., Ph.D. The University of Texas MD Anderson Cancer Center, Houston, Texas Oberndofer 1907 Illeal Serotonin Secreting Tumor Carcinoid (Karzinoide) 1 Histogenesis 16 different

More information

An Overview of NETS. Richard R.P. Warner M.D

An Overview of NETS. Richard R.P. Warner M.D An Overview of NETS Richard R.P. Warner M.D Diagnosis and Treatment Approaches Carcinoid (and other NETs) not as benign as originally described 13-50% of all carcinoids have distant metastases when first

More information

PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES

PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES PRINCESS MARGARET CANCER CENTRE CLINICAL PRACTICE GUIDELINES GASTROINTESTINAL NEUROENDOCRINE GASTRO-ENTERO-PANCREATIC TUMOURS GI Site Group Neuroendocrine gastro-entero-pancreatic tumours Authors: Dr.

More information

*Bert Bakker was an employee of Novartis Pharmaceuticals Corporation until June 06, 2014.

*Bert Bakker was an employee of Novartis Pharmaceuticals Corporation until June 06, 2014. Page 1 of 20 Accepted Preprint first posted on 15 September 2015 as Manuscript ERC-15-0314 1 2 Efficacy of Octreotide LAR in Neuroendocrine Tumors: RADIANT-2 Placebo Arm Post Hoc Analysis 3 4 Authors:

More information

Systemic Therapy for Gastroenteropancreatic (GEP) Neuroendocrine Tumors and Lung Carcinoid

Systemic Therapy for Gastroenteropancreatic (GEP) Neuroendocrine Tumors and Lung Carcinoid Systemic Therapy for Gastroenteropancreatic (GEP) Neuroendocrine Tumors and Lung Carcinoid The Medical Oncology Perspective Nevena Damjanov, MD Associate professor Abramson Cancer Center of the University

More information

An Open-Label Phase Ib/II Study of Sulfatinib in Patients with Advanced Neuroendocrine Tumors (NCT )

An Open-Label Phase Ib/II Study of Sulfatinib in Patients with Advanced Neuroendocrine Tumors (NCT ) An Open-Label Phase Ib/II Study of Sulfatinib in Patients with Advanced Neuroendocrine Tumors (NCT02267967) J.M. Xu a, J. Li b, C.M. Bai c, N. Xu d, Z.W. Zhou e, Z.P. Li f, C.C. Zhou g, W. Wang h, J. Li

More information

2015: Year in Review Results of Recent Trials

2015: Year in Review Results of Recent Trials 2015: Year in Review Results of Recent Trials Pamela L. Kunz, MD Assistant Professor of Medicine / GI Oncology Director, Stanford NET Program Stanford University School of Medicine Disclosures Research

More information

Diagnosing and monitoring NET

Diagnosing and monitoring NET Diagnosing and monitoring NET Inaccurate or delayed diagnosis of neuroendocrine tumors (NET) is common, because many NET are small and asymptomatic. 1 When symptoms are present, they are usually nonspecific

More information

TUMORES NEUROENDOCRINOS. Miguel Navarro. Salamanca

TUMORES NEUROENDOCRINOS. Miguel Navarro. Salamanca TUMORES NEUROENDOCRINOS Miguel Navarro. Salamanca Introduction to Neuroendocrine Tumours (NETs) NETs are relatively RARE At least 40 different entities are described arising in different organs. Different

More information

pan-canadian Oncology Drug Review Final Clinical Guidance Report Sunitinib malate (Sutent) for pancreatic neuroendocrine tumours May 3, 2012

pan-canadian Oncology Drug Review Final Clinical Guidance Report Sunitinib malate (Sutent) for pancreatic neuroendocrine tumours May 3, 2012 pan-canadian Oncology Drug Review Final Clinical Guidance Report Sunitinib malate (Sutent) for pancreatic neuroendocrine tumours May 3, 2012 DISCLAIMER Not a Substitute for Professional Advice This report

More information

Review Article Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature

Review Article Management Options for Advanced Low or Intermediate Grade Gastroenteropancreatic Neuroendocrine Tumors: Review of Recent Literature Hindawi International Journal of Surgical Oncology Volume 2017, Article ID 6424812, 14 pages https://doi.org/10.1155/2017/6424812 Review Article Management Options for Advanced Low or Intermediate Grade

More information

Hepatic metastases of neuroendocrine tumors: treatment options and outcomes of local patients treated with radioembolization

Hepatic metastases of neuroendocrine tumors: treatment options and outcomes of local patients treated with radioembolization Hepatic metastases of neuroendocrine tumors: treatment options and outcomes of local patients treated with radioembolization JP King PGY2 May 22, 2015 Neuroendocrine Tumor (NET) WHO Classification Location

More information

sunitinib 12.5mg, 25mg, 37.5mg, 50mg hard capsules (Sutent ) SMC No. (698/11) Pfizer Limited

sunitinib 12.5mg, 25mg, 37.5mg, 50mg hard capsules (Sutent ) SMC No. (698/11) Pfizer Limited sunitinib 12.5mg, 25mg, 37.5mg, 50mg hard capsules (Sutent ) SMC No. (698/11) Pfizer Limited 08 April 2011 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and

More information

Neuroendocrine Tumours If you don t suspect it you can t detect it! Dr JWS Devar HPB Surgeon University of Witwatersrand E-AHPBA CHBAH & WDGMC

Neuroendocrine Tumours If you don t suspect it you can t detect it! Dr JWS Devar HPB Surgeon University of Witwatersrand E-AHPBA CHBAH & WDGMC Neuroendocrine Tumours If you don t suspect it you can t detect it! Dr JWS Devar HPB Surgeon University of Witwatersrand E-AHPBA CHBAH & WDGMC Case Study 43 yr old female with a history of a left mastectomy

More information

Addison's disease Neuroendocrine tumors Paraneoplastic syndromes

Addison's disease Neuroendocrine tumors Paraneoplastic syndromes Addison's disease Neuroendocrine tumors Paraneoplastic syndromes Miklós Tóth Professor of Medicine and Endocrinology 9 th April, 2018 Semmelweis University 2nd Department of Medicine Addison's disease

More information

NeuroEndocrine Tumors Diagnostic and therapeutic challenges: introduction

NeuroEndocrine Tumors Diagnostic and therapeutic challenges: introduction NeuroEndocrine Tumors Diagnostic and therapeutic challenges: introduction Prof Eric Van Cutsem, MD, PhD Gastroenterology/Digestive Oncology Leuven, Belgium Eric.VanCutsem@uzleuven.be Diagnostic & therapeutic

More information

Treatment algorithm Neuroendocrine tumours. Gregory Kaltsas Endocrine Unit, Department of Pathophysiology, University of Athens, Greece

Treatment algorithm Neuroendocrine tumours. Gregory Kaltsas Endocrine Unit, Department of Pathophysiology, University of Athens, Greece Treatment algorithm Neuroendocrine tumours Gregory Kaltsas Endocrine Unit, Department of Pathophysiology, University of Athens, Greece Outline Presenting a meaningful algorithm Means used to develop algorithm

More information

NEUROENDOCRINE TUMOURS Updated December 2015 by Dr. Doreen Ezeife (PGY-5 Medical Oncology Resident, University of Calgary)

NEUROENDOCRINE TUMOURS Updated December 2015 by Dr. Doreen Ezeife (PGY-5 Medical Oncology Resident, University of Calgary) NEUROENDOCRINE TUMOURS Updated December 2015 by Dr. Doreen Ezeife (PGY-5 Medical Oncology Resident, University of Calgary) Reviewed by Dr. Cynthia Card (Staff Medical Oncologist, University of Calgary)

More information

Community Case. Saeed Awan R5

Community Case. Saeed Awan R5 Community Case Saeed Awan R5 18 year old presents to ER with history of pain right lower quadrant for three days. Nauseated, denies vomiting and bowel movements normal and no urinary complaint. Admitted

More information

New Developments in the Care and Management of Patients with Gastroenteropancreatic Neuroendocrine Tumors Dr. Tim Asmis The Ottawa Hospital Cancer

New Developments in the Care and Management of Patients with Gastroenteropancreatic Neuroendocrine Tumors Dr. Tim Asmis The Ottawa Hospital Cancer New Developments in the Care and Management of Patients with Gastroenteropancreatic Neuroendocrine Tumors Dr. Tim Asmis The Ottawa Hospital Cancer Centre MD, FRCPC CAGPO September 2018 Disclosures Consultant

More information

NICaN Pancreatic Neuroendocrine Tumour SACT protocols. 1.0 Dr M Eatock Final version issued

NICaN Pancreatic Neuroendocrine Tumour SACT protocols. 1.0 Dr M Eatock Final version issued Reference No: Title: Author(s) Systemic Anti-Cancer Therapy (SACT) Guidelines for Pancreatic Neuro-endocrine Tumours Dr Martin Eatock, Consultant Medical Oncologist & on behalf of the GI Oncologists Group,

More information

EVEROLIMUS SANDOZ (everolimus)

EVEROLIMUS SANDOZ (everolimus) EVEROLIMUS SANDOZ (everolimus) NAME OF THE MEDICINE The active ingredient of EVEROLIMUS SANDOZ is everolimus. The chemical name is 40-O-(2-hydroxyethyl)-rapamycin or 40-O-(2-hydroxyethyl)-sirolimus. Its

More information

Horizon Scanning in Oncology

Horizon Scanning in Oncology Horizon Scanning in Oncology Everolimus (Afinitor ) for the treatment of unresectable or metastatic neuroendocrine tumours of pancreatic origin DSD: Horizon Scanning in Oncology Nr. 024 ISSN online 2076-5940

More information

Update on Surgical Management of NETs

Update on Surgical Management of NETs Update on Surgical Management of Neuroendocrine Tumors James R. Howe, M.D. Director, Surgical Oncology and Endocrine Surgery University of Iowa College of Medicine Distribution of NETs 2000-2004 27% ---

More information

Sandostatin LAR. Sandostatin LAR (octreotide acetate) Description

Sandostatin LAR. Sandostatin LAR (octreotide acetate) Description Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.30.09 Subject: Sandostatin LAR Page: 1 of 5 Last Review Date: March 16, 2018 Sandostatin LAR Description

More information

lutetium ( 177 Lu) oxodotreotide 370MBq/mL solution for infusion (Lutathera ) SMC No 1337/18 Advanced Accelerator Applications

lutetium ( 177 Lu) oxodotreotide 370MBq/mL solution for infusion (Lutathera ) SMC No 1337/18 Advanced Accelerator Applications lutetium ( 177 Lu) oxodotreotide 370MBq/mL solution for infusion (Lutathera ) SMC No 1337/18 Advanced Accelerator Applications 8 June 2018 The Scottish Medicines Consortium (SMC) has completed its assessment

More information

Tumor markers. Chromogranin A. Analyte Information

Tumor markers. Chromogranin A. Analyte Information Tumor markers Chromogranin A Analyte Information -1-2018-04-22 Chromogranin A Introduction Chromogranin A (CgA) is a 439-amino acid protein with a molecular weight of 48 to 60 kda, depending on glycosylation

More information

OVERVIEW OF THE DIAGNOSIS AND TREATMENT OF GI NETS

OVERVIEW OF THE DIAGNOSIS AND TREATMENT OF GI NETS OVERVIEW OF THE DIAGNOSIS AND TREATMENT OF GI NETS Dr Christos G. Toumpanakis MD PhD FRCP FEBGH Consultant in Gastroenterology/Neuroendocrine Tumours Hon. Senior Lecturer University College of London Neuroendocrine

More information

Carcinoma de Tiroide: Teràpies Diana

Carcinoma de Tiroide: Teràpies Diana Carcinoma de Tiroide: Teràpies Diana Jaume Capdevila, MD GI and Endocrine Tumor Unit Vall d Hebron University Hospital Developmental Therapeutics Unit Vall d Hebron Institute of Oncology THYROID CANCER:

More information

Evolving Paradigms in HER2+ MBC: Strategies for Individualizing Therapy with Available Agents

Evolving Paradigms in HER2+ MBC: Strategies for Individualizing Therapy with Available Agents Evolving Paradigms in HER2+ MBC: Strategies for Individualizing Therapy with Available Agents Kimberly L. Blackwell MD Professor Department of Medicine and Radiation Oncology Duke University Medical Center

More information

Everolimus Plus Octreotide Long-Acting Repeatable in Patients With Advanced Lung Neuroendocrine Tumors

Everolimus Plus Octreotide Long-Acting Repeatable in Patients With Advanced Lung Neuroendocrine Tumors CHEST Original Research Everolimus Plus Octreotide Long-Acting Repeatable in Patients With Advanced Lung Neuroendocrine Tumors Analysis of the Phase 3, Randomized, Placebo-Controlled RADIANT-2 Study LUNG

More information

This clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.

This clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data. abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical

More information

Management of Pancreatic Islet Cell Tumors

Management of Pancreatic Islet Cell Tumors Management of Pancreatic Islet Cell Tumors Ravi Dhanisetty, MD November 5, 2009 Morbidity and Mortality Conference Case Presentation 42 yr female with chronic abdominal pain. PMHx: Uterine fibroids Medications:

More information

Systematic Review of the Role of Targeted Therapy in Metastatic Neuroendocrine Tumors

Systematic Review of the Role of Targeted Therapy in Metastatic Neuroendocrine Tumors At the Cutting Edge Received: February 29, 2016 Accepted: April 12, 2016 Published online: April 16, 2016 Systematic Review of the Role of Targeted Therapy in Metastatic Neuroendocrine Tumors Adrian Lee

More information

Neuroendocrine Tumors Positron Emission Tomography (PET) Imaging and Peptide Receptor Radionuclide Therapy

Neuroendocrine Tumors Positron Emission Tomography (PET) Imaging and Peptide Receptor Radionuclide Therapy Neuroendocrine Tumors Positron Emission Tomography (PET) Imaging and Peptide Receptor Radionuclide Therapy Lawrence Saperstein, M.D. Assistant Professor of Radiology and Biomedical Imaging Chief, Nuclear

More information

ENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID

ENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID ENDOLUMINAL APPROACH FOR THE MANAGEMENT OF GASTROINTESTINAL CARCINOID Manoop S. Bhutani, MD, FASGE, FACG, FACP, AGAF, Doctor Honoris Causa Professor of Medicine Eminent Scientist of the Year 2008, World

More information

Therapeutic Radiopharmaceuticals in Oncology

Therapeutic Radiopharmaceuticals in Oncology Therapeutic Radiopharmaceuticals in Oncology Policy Number: 6.01.60 Last Review: 9/2018 Origination: 9/2018 Next Review: 9/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage

More information

NEUROENDOCRINE CARCINOID TUMORS PANCREATIC NEUROENDOCRINE TUMORS

NEUROENDOCRINE CARCINOID TUMORS PANCREATIC NEUROENDOCRINE TUMORS University of Miami Jackson Memorial Hospital Role of the Surgeon in the Approach to Neuroendocrine tumors Dido Franceschi, MD Professor of Surgery University of Miami Karzinoide Siegfried Oberndorfer,

More information

Long Term Results in GIST Treatment

Long Term Results in GIST Treatment Long Term Results in GIST Treatment Dr. Laurentia Gales Prof. Dr. Rodica Anghel, Dr. Xenia Bacinschi Institute of Oncology Prof Dr Al Trestioreanu Bucharest 25 th RSRMO October 15-17 Sibiu Background Gastrointestinal

More information

SCOPE TODAYS SESSION. Case 1: Case 2. Basic Theory Stuff: Heavy Stuff. Basic Questions. Basic Questions

SCOPE TODAYS SESSION. Case 1: Case 2. Basic Theory Stuff: Heavy Stuff. Basic Questions. Basic Questions MONDAY TEACHING SCOPE TODAYS SESSION Case 1: Basic Questions Case 2 Basic Questions Basic Theory Stuff: AJCC TNM + Stage Group for Carcinoid of the Appendix Management of Carcinoid of the Appendix (NCCN)

More information

Guideline A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO)

Guideline A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Systemic Therapy of Incurable Gastroenteropancreatic Neuroendocrine Tumours S. Singh, D. Sivajohanathan, T.

More information

Surgical Therapy of GEP-NET: An Overview

Surgical Therapy of GEP-NET: An Overview Surgical Therapy of GEP-NET: An Overview Pierce K.H Chow MBBS, MMed, FRCSE, FAMS, PhD Professor, Duke-NUS Graduate School of Medicine Senior Consultant Surgeon, Singapore General Hospital Visiting Senior

More information

Pembrolizumab for Patients With PD-L1 Positive Advanced Carcinoid or Pancreatic Neuroendocrine Tumors: Results From the KEYNOTE-028 Study

Pembrolizumab for Patients With PD-L1 Positive Advanced Carcinoid or Pancreatic Neuroendocrine Tumors: Results From the KEYNOTE-028 Study Pembrolizumab for Patients With PD-L1 Positive Advanced Carcinoid or Pancreatic Neuroendocrine Tumors: Results From the KEYNOTE-28 Study Abstract 427O Mehnert JM, Bergsland E, O Neil BH, Santoro A, Schellens

More information

Primary Endpoint The primary endpoint is overall survival, measured as the time in weeks from randomization to date of death due to any cause.

Primary Endpoint The primary endpoint is overall survival, measured as the time in weeks from randomization to date of death due to any cause. CASE STUDY Randomized, Double-Blind, Phase III Trial of NES-822 plus AMO-1002 vs. AMO-1002 alone as first-line therapy in patients with advanced pancreatic cancer This is a multicenter, randomized Phase

More information

Index. Surg Oncol Clin N Am 15 (2006) Note: Page numbers of article titles are in boldface type.

Index. Surg Oncol Clin N Am 15 (2006) Note: Page numbers of article titles are in boldface type. Surg Oncol Clin N Am 15 (2006) 681 685 Index Note: Page numbers of article titles are in boldface type. A Ablative therapy, for liver metastases in patients with neuroendocrine tumors, 517 with radioiodine

More information

2 nd line Therapy and Beyond NSCLC. Alan Sandler, M.D. Oregon Health & Science University

2 nd line Therapy and Beyond NSCLC. Alan Sandler, M.D. Oregon Health & Science University 2 nd line Therapy and Beyond NSCLC Alan Sandler, M.D. Oregon Health & Science University Treatment options for advanced or metastatic (stage IIIb/IV) NSCLC Suitable for chemotherapy Diagnosis Unsuitable/unwilling

More information

SIRT in Neuroendocrine Tumors

SIRT in Neuroendocrine Tumors SIRT in Neuroendocrine Tumors Marnix G.E.H. Lam, MD PhD Professor of Nuclear Medicine AVL Amsterdam UMC Utrecht ENETS Center of Excellence, The Netherlands Disclosure of speaker s interests Consultant

More information

Targeted Agents as Maintenance Therapy. Karen Kelly, MD Professor of Medicine UC Davis Cancer Center

Targeted Agents as Maintenance Therapy. Karen Kelly, MD Professor of Medicine UC Davis Cancer Center Targeted Agents as Maintenance Therapy Karen Kelly, MD Professor of Medicine UC Davis Cancer Center Disclosures Genentech Advisory Board Maintenance Therapy Defined Treatment Non-Progressing Patients Drug

More information

Understanding Biological Activity to Inform Drug Development

Understanding Biological Activity to Inform Drug Development National Cancer Policy Forum Understanding Biological Activity to Inform Drug Development December 12, 2016 Wolfgang Weber Molecular Imaging and Therapy Service Department of Radiology RECIST Response

More information

Neuroendocrine & Carcinoid Tumors

Neuroendocrine & Carcinoid Tumors Neuroendocrine & Carcinoid Tumors Acknowledgment This slide set was medically reviewed by Dr. Yi-Zarn Wang, DDS, PC, MD, FACS in August 2018. Workshop Overview Introductions What Are Neuroendocrine Tumors

More information

Virtual Journal Club: Front-Line Therapy and Beyond Recent Perspectives on ALK-Positive Non-Small Cell Lung Cancer.

Virtual Journal Club: Front-Line Therapy and Beyond Recent Perspectives on ALK-Positive Non-Small Cell Lung Cancer. Virtual Journal Club: Front-Line Therapy and Beyond Recent Perspectives on ALK-Positive Non-Small Cell Lung Cancer Reference Slides ALK Rearrangement in NSCLC ALK (anaplastic lymphoma kinase) is a receptor

More information

Peptide Receptor Radionuclide Therapy using 177 Lu octreotate

Peptide Receptor Radionuclide Therapy using 177 Lu octreotate Peptide Receptor Radionuclide Therapy using 177 Lu octreotate BLR Kam, Erasmus Medical Centre, Rotterdam DJ Kwekkeboom, Erasmus Medical Centre, Rotterdam Legal aspects As 177 Lu-[DOTA 0 -Tyr 3 ]octreotate

More information

ESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT

ESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT ESMO 2017, Madrid, Spain Dr. Loredana Vecchione Charite Comprehensive Cancer Center, Berlin HIGHLIGHTS ON CANCERS OF THE UPPER GI TRACT DOCETAXEL, OXALIPLATIN AND FLUOROURACIL/LEUCOVORIN (FLOT) FOR RESECTABLE

More information

CRITICAL ANALYSIS OF NEN GUIDELINES. G Pentheroudakis Associate Professsor of Oncology Medical School, University of Ioannina Chair, ESMO Guidelines

CRITICAL ANALYSIS OF NEN GUIDELINES. G Pentheroudakis Associate Professsor of Oncology Medical School, University of Ioannina Chair, ESMO Guidelines CRITICAL ANALYSIS OF NEN GUIDELINES G Pentheroudakis Associate Professsor of Oncology Medical School, University of Ioannina Chair, ESMO Guidelines DISCLOSURES NO CONFLICTS OF INTEREST TO DECLARE UPDATED

More information

Session 6 NEW TECHNIQUES IN RADIATION TREATMENT. Chairman : Françoise MORNEX

Session 6 NEW TECHNIQUES IN RADIATION TREATMENT. Chairman : Françoise MORNEX Session 6 NEW TECHNIQUES IN RADIATION TREATMENT Chairman : Françoise MORNEX INTERNAL IRRADIATION FOR ENDOCRINE TUMORS Emmanuel DESHAYES INTERNAL IRRADIATION FOR ENDOCRINE TUMORS Dr Emmanuel DESHAYES Nuclear

More information

EGFR inhibitors in NSCLC

EGFR inhibitors in NSCLC Suresh S. Ramalingam, MD Associate Professor Director of Medical Oncology Emory University i Winship Cancer Institute EGFR inhibitors in NSCLC Role in 2nd/3 rd line setting Role in first-line and maintenance

More information

A New Proposal for Metabolic Classification of NENs Stefano Severi IRST Meldola Italy

A New Proposal for Metabolic Classification of NENs Stefano Severi IRST Meldola Italy RADIONUCLIDE THERAPY AND ALLIED SCIENCE President: Giovanni Paganelli Chairman: Maria Salvato Baltimore USA Domenico Barone Meldola Italy A New Proposal for Metabolic Classification of NENs Stefano Severi

More information

This clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data.

This clinical study synopsis is provided in line with Boehringer Ingelheim s Policy on Transparency and Publication of Clinical Study Data. abcd Clinical Study for Public Disclosure This clinical study synopsis is provided in line with s Policy on Transparency and Publication of Clinical Study Data. The synopsis which is part of the clinical

More information

Color Codes Pathology and Genetics Medicine and Clinical Pathology Surgery Imaging

Color Codes Pathology and Genetics Medicine and Clinical Pathology Surgery Imaging Saturday, November 5, 2005 8:30-10:30 a. m. Poorly Differentiated Endocrine Carcinomas Chairman: E. Van Cutsem, Leuven, Belgium 9:00-9:30 a. m. Working Group Sessions Pathology and Genetics Group leaders:

More information