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0:00
So thank you for the opportunity
to speak today.
My name is Nitya Raj.
I am one of the Assistant
Attending Physicians
in the Gastrointestinal
Oncology Service
at Memorial Sloan
Kettering Cancer Center.
My clinical practice is devoted
to the care of patients
with gastrointestinal cancers,
particularly neuroendocrine tumors.
And I'm a clinical researcher
who focuses my research activities
on identifying new therapies
for patients
with neuroendocrine tumors.
In addition,
I'm also studying ways to improve
our understanding
of the tumor biology
of this rare group of cancers,
particularly understanding
how neuroendocrine tumors
change genetically over time
and as a result
of different treatments.
So today,
I'm going to be speaking to you
about immunotherapy
in neuroendocrine tumors.
0:51
Okay, so here is the agenda
that we'll be focusing on today.
First, I'm going to give
a brief background
on neuroendocrine tumors.
I'll then highlight
our current therapy options
that are available as of 2016.
I'll move on to then discuss
what has already been done
to evaluate for a role
of immunotherapy,
and I'm going to take us back
to what's been done previously
both in the clinic
and in the lab,
and I'll conclude the talk
by discussing
where we can go from here
and how we can use the data
we already have
to develop clinical trials
for immunotherapy
in neuroendocrine tumors.
1:31
So just to give a brief background
on neuroendocrine tumors,
and I'd like to begin my talk
by using the phrase,
"What's in a name?"
And I'd like to use this phrase
to really emphasize
that neuroendocrine tumors
can develop anywhere
in the body.
Although,
this is a rare group of cancers,
they are increasing
in both incidence and prevalence
just in the past few decades.
So in the early 1970s,
the incidence was estimated
at 1 per 100,000 cases,
and more recently,
it is now rising
to approximately 5 per 100,000.
It's unknown if this trend
of increasing incidence
and prevalence
is truly due to better
recognition of the tumors
rather than an increase
in incidence and prevalence.
These tumors are classified
by their location,
and the big distinction comes
from whether they begin
in the pancreas or not.
And so tumors that start outside
of the pancreas
are often termed carcinoid tumors
whereas those that begin
in the pancreas
are termed pancreatic
neuroendocrine tumors.
The primary sites of origin,
neuroendocrine tumors are either
in the gastrointestinal tract
or in the thoracic cavity.
And the majority of our patients
present with advanced
metastatic disease
as these tumors
are often characterized
by indolent behavior
and symptom
and are only recognized
after much progression,
