NET news from ESMO16

Update on the NET news from ESMO in Copenhagen – the biggest congress so far attended by over 20 500 delegates from 124 countries.

Clinical benefit demonstrated with everolimus and pasireotide LAR alone or in combination in the first randomised, prospective study entirely dedicated to advanced lung and thymic carcinoids

In patients with advanced lung or thymus carcinoid receiving everolimus, pasireotide LAR or the combination of the two drugs, statistically significant positive impact was seen on proportion of patients’ progression free at 9 months (primary endpoint) in all three arms, more relevant in the combination arm, according to phase II study findings presented at the ESMO 2016 by Piero Ferolla. The LUNA is the first randomised trial specifically designed for patients with lung and thymic carcinoids. (416O) Read more here

The NETwork! translational programme facilitates genomic analysis of neuroendocrine tumours

The first findings of genetic analyses performed within NETwork!, a clinical and ethical framework that was established to support, interpret, and return genomic analyses of neuroendocrine tumours (NETs) were reported at ESMO 2016 by Ben Lawrence. Performing deep genomics of the carefully annotated and described pNETs produced new insights into NET tumourigenesis, which enabled rational and perhaps unexpected therapeutic choice to be applied in clinical trials. (418O)

Metformin significantly lowers the risk of cancer progression in patients with diabetes and advanced pNETs

A retrospective evaluation of patients receiving treatment for pancreatic neuroendocrine tumours (pNETs) showed that patients with diabetes had longer progression-free survival than non-diabetic (normoglycaemic) patients. Patients treated with metformin for diabetes also had the lowest risk of pNETs progression compared to non-diabetic patients, according to findings reported by Sara Pusceddu at ESMO 2016. (417O)

The themes in 2016 as summarized by Prof. Juan W Valle from the University of Manchester in Today’s ESMO Highlights:
1. Focus on pulmonary NETs (predominantly well-differentiated NETs)
·         Activity of Everolimus confirmed in pulmonary NETS… independed of prior Rx
·         The addition of pasireotide remains investigational
·         68GA imaging may inform management-changing information
2. Novel therapeutics (updates and new directions)
·         17Lu not only maintains but improves QoL
·         Teloristat safety: no major safety issues in first 12 weeks of treatment
·         The use of metformin requires prospective robust evaluation
3. Increasing understanding of genomic landscape
·         the search of actionable targets is increasingly feasible and clinically relevant for some patients
In addition,  ESMO has placed a focused effort in involving patients in the programme, with an extremely substantial patient advocacy track, which was massively attended. Notably, ESMO has officially recognized patient advocates as healthcare professionals and has opened membership to patient advocates with full voting rights.