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Immunotherapy in neuroendocrine tumors 1 - current available therapy options
Published on January 30, 2017 18 min
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- Prof. Kevin Harrington
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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.
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.
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,