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Finding the Answer to NET Cancer

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Matthew H. Kulke and Jennifer Chan discuss neuroendocrine tumors (NETs), which can occur in any organ that has endocrine cells.

Published in: Health & Medicine

Finding the Answer to NET Cancer

  1. 1. Program in Neuroendocrine and Carcinoid Tumors
  2. 2. What is NET Cancer?  Neuroendocrine tumors (NETs) can occur in any organ that has endocrine cells. Sometimes Neuroendocrine tumors are called carcinoid tumors.  They are found in both adults and children.  They appear most often in the small intestine, appendix, pancreas, and lungs but can also be found in the thyroid, breast, ovaries and prostate.  NETs are difficult to diagnose and many patients have vague symptoms such as abdominal pain, flushing, or diarrhea for eight or nine years before the correct diagnosis is made.  Tumors have often metastasized by the time they are diagnosed.  NETs don’t respond to most chemotherapy drugs, and very few of the new targeted drugs are effective. Surgery is the only cure and once the NET has metastasized, it is difficult to remove the complete tumor. Program in Neuroendocrine and Carcinoid Tumors
  3. 3. Types of neuroendocrine tumors  Neuroendocrine tumors are usually classified as either pancreatic endocrine tumors which start in the pancreas or carcinoid tumors which start in other organs. Carcinoid tumors most commonly start in the lungs, small intestine, appendix, or rectum. Program in Neuroendocrine and Carcinoid Tumors
  4. 4. Treatment approaches  When neuroendocrine tumors are detected at an early stage, before there has been spread to other organs, they can usually be removed surgically.  Liver-directed therapies: Often involves embolization, an interventional radiology procedure to cut off the blood supply to the liver metastases.  Somatostatin analogs: Most neuroendocrine tumors have receptors for the naturally occurring hormone somatostatin. Synthetic somatostatin analogs are available that mimic the action of somatostatin and can be used to treat neuroendocrine tumors.  Chemotherapy  Interferon: Interferon is considered a biological agent. It is administered using a subcutaneous injection.  Targeted therapies Program in Neuroendocrine and Carcinoid Tumors
  5. 5. Incidence  In excess of 100,000 people living with NET cancer in the US  16,000 new diagnoses each year in US  Estimated more than 200,000 undiagnosed cases in the US  Time from onset of symptoms to proper diagnosis often exceeds five years Program in Neuroendocrine and Carcinoid Tumors
  6. 6. Government Funding  Government funding for NET research is less than $3 million annually.  In 2017 it is estimated that government funding for breast and colorectal cancers is $699 million and $331 million respectively.  Government funding for NET represents less than 1% of what is spent on more common malignancies. Program in Neuroendocrine and Carcinoid Tumors
  7. 7. About Dana-Farber Unique Approach • Dana-Farber’s 50/50 balance of research and patient care is the cornerstone of our lifesaving mission. • This powerful integration results in new discoveries and innovations that benefit patients faster. Breakthrough Clinical Trials • With one of the largest clinical trials programs in the country, Dana-Farber offers eligible patients the opportunity to access the latest advances in experimental therapies. Expansive Collaboration • Dana-Farber’s team science model encourages lab scientists to work in tandem with clinicians, as well as across the Harvard Medical School system, with MIT and the Broad Institute, as well as preeminent research institutions around the world. Next Generation Drug Discovery • Dana-Farber investigators are creating new laboratory models of cancers and testing new drugs. • Dana-Farber chemical biologists are creating new drug compounds to expand therapeutic options for patients. Program in Neuroendocrine and Carcinoid Tumors
  8. 8. Leadership Matthew H. Kulke – Director, Program in Neuroendocrine and Carcinoid-Tumors DF/BWCC Center for Gastrointestinal Oncology Department Medical Oncology Professor of Medicine, Harvard Medical School Jennifer Chan – Clinical Director, Program in Neuroendocrine and Carcinoid Tumors DF/BWCC Center for Gastrointestinal Oncology Department Medical Oncology Instructor of Medicine, Harvard Medical School Program in Neuroendocrine and Carcinoid Tumors
  9. 9. Program in Neuroendocrine and Carcinoid Tumors
  10. 10. CHALLENGES: NET Research  Neuroendocrine tumors are notoriously challenging to treat, and only ten years ago few treatment options were available for patients.  Sparse dedicated private funding sources and very few private foundations dedicated to neuroendocrine tumor research  Lack of laboratory models of NETS to test promising new treatments  Very little public awareness about the disease Program in Neuroendocrine and Carcinoid Tumors
  11. 11. Collect tumor and blood specimens Analyze specimens to discover key pathways critical to driving tumor growth I. Identify Treatment Targets II. Validate Treatment Targets in Patient- Derived Tumor Models III. Evaluate in Clinical Trials Take promising treatments to clinical trials Use patient-derived tumor models to confirm that targeting pathways impairs NET growth Identifying New Treatments for NET at DFCI: A Patient-Based Approach Bring new treatments to patients Molecular and genetic analysis Program in Neuroendocrine and Carcinoid Tumors
  12. 12. Philanthropy is Catalytic… For patients and families who are awaiting the next breakthrough treatment for neuroendocrine cancer, we need a partnership between science and visionary philanthropy to more rapidly pave the way for new therapies and shape the future of cancer care. I. People  Scientists to advance the study of laboratory model systems and new targets for therapy II. Program  Discover and validate new therapeutic targets and test new drugs Program in Neuroendocrine and Carcinoid Tumors
  13. 13. Summary  Neuroendocrine cancer is a deadly disease that has had insufficient research attention and funding  We now have potential to dramatically advance our understanding of these cancers and to develop more effective rational therapies to precisely target the drivers of tumor growth  We have a unique combination of research and clinical efforts to attack these cancers and are developing an integrated program to make real progress Program in Neuroendocrine and Carcinoid Tumors

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