Neuroendocrine neoplasms are derived from the diffuse endocrine system and represent a spectrum of tumours with a diverse range of molecular abnormalities, functionality and anatomical locations. Here, some key advances in molecular diagnosis, functional imaging and therapeutic strategies that have been published in 2020 are discussed.
The 68Ga somatostatin analogue PET-CT has a higher diagnostic accuracy for well-differentiated grade I and II NENs than 18F-fluorodeoxyglucose PET-CT4.
Peptide receptor radionuclide therapy with 177Lu DOTA-TATE has improved outcomes for patients with 68Ga-DOTA-somatostatin receptor-positive advanced well-differentiated NENs5.
Findings from immunotherapy trials for patients with NENs have been somewhat disappointing in patients with low-grade NENs. However, analysis of immune-related genes in pancreatic NENs suggests that patients might be stratified by molecular subtypes and immune-related gene expression9.
Surgery with a radical intent could be a valid option for patients with grade III gastroenteropancreatic-NETs with Ki67 <55%10.
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Capdevila, J. et al. 1157O A multi-cohort phase II study of durvalumab plus tremelimumab for the treatment of patients (pts) with advanced neuroendocrine neoplasms (NENs) of gastroenteropancreatic or lung origin: The DUNE trial (GETNE 1601). Ann. Oncol. 31, S770–S771 (2020).
Young, K. et al. Immune landscape, evolution, hypoxia-mediated viral mimicry pathways and therapeutic potential in molecular subtypes of pancreatic neuroendocrine tumours. Gut https://doi.org/10.1136/gutjnl-2020-321016 (2020).
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M.E.C. has received speaker honoraria and research funding from AAA-Novartis, Ipsen and Pfizer. G.M.R. declares no competing interests.
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Caplin, M.E., Ratnayake, G.M. Diagnostic and therapeutic advances in neuroendocrine tumours. Nat Rev Endocrinol 17, 81–82 (2021). https://doi.org/10.1038/s41574-020-00458-x