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Evolving management options for pancreatic neuroendocrine tumors to be reviewed

Growing evidence suggests that pancreatic neuroendocrine tumors (PNET) are more common than previously thought. Four experts will discuss the latest data during Sunday’s DDW Clinical Symposium Recent Advances in Neuroendocrine Tumors of the Pancreas, which is jointly sponsored by AGA and SSAT.
Symposium co-moderator Daniel Chung, MD, clinical chief of the gastrointestinal unit and director of the High-Risk GI Cancer Clinic at Massachusetts General Hospital, Boston, said the need for multidisciplinary management of PNETs makes this an important topic for gastroenterologists and surgeons.

“Gastroenterologists are often the first to make the diagnosis of a PNET. In many cases, we can just observe,” he said. “In some cases, surgery is the right choice, and for patients with more advanced disease, chemotherapy would be appropriate.”

Dr. Chung will begin the symposium with a presentation on titled “Molecular Pathogenesis of Pancreatic NETs.” He will provide an overview of the scientific understanding of genetic abnormalities that lead to PNET formation.

“Historically, these tumors have been poorly understood on the genetic level,” he said. “In the past few years, we’ve gained tremendous new insights. Understanding these tumors on a molecular level can serve as a foundation to develop new diagnostic and therapeutic strategies.”
Yusuf Menda, MD, of the University of Iowa, Iowa City, will discuss the role of gallium scanning for imaging NETs.

“The options for imaging PNETs are rapidly expanding,” Dr. Chung said. “One of the newest is gallium scanning, which appears to be one of the most sensitive modalities to date. It’s important to understand when it’s appropriate to use more conventional modalities such as CT or MRI, and when someone might need more sophisticated imaging such as gallium scanning.”

Douglas Evans, MD, of the Medical College of Wisconsin, Milwaukee, will then discuss surgical options for the management of PNETs.

“One of the biggest questions is what to do with a small, incidental PNET,” Dr. Chung said. “Often they can behave in a benign way, but we don’t have good markers to understand which ones will remain indolent and which ones will progress. Dr. Evans will also review the role of debulking surgery for patients with more extensive disease.”

The session’s final presenter, Nitya Raj, MD, of Memorial Sloan Kettering Cancer Center, New York, will present a lecture titled “Current Chemotherapeutic Strategies for Advanced Pancreatic NETS (Including PRRT).”

“Traditionally, we have not had very good therapies for advanced disease,” Dr. Chung said. “In recent years, many new agents have been introduced that provide better options for patients. Some of the more exciting approaches are targeted therapies that exploit the hormonal phenotype of these tumors.”

Please refer to the DDW Mobile App or the Program section in Sunday’s DDW Daily News for additional details on this and other DDW® events.

One Response

  1. Dear colleagues. What is the experts opinion about lymph node dissection during the surgery in patients with pNET in terms of size or localization in part of the pancreas?

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