There is always research going on in the field of gastrointestinal (GI) carcinoids. Scientists are looking for the causes of, ways to prevent, and new approaches to diagnose and treat GI carcinoid tumors.

Genetics

Researchers are looking for the causes of neuroendocrine tumors/cancers in the hopes that this knowledge can be used to help prevent or treat the disease in the future. A great deal of progress has been made in recent years. For example, scientists have found that changes in the MEN1 gene (the gene that causes multiple endocrine neoplasia, type 1) are seen in many people with GI carcinoids. Other genetic changes that seem to make tumors more aggressive are now being explored as well.

Diagnosis and staging

Because the outlook and treatment of GI neuroendocrine tumors/cancers and other cancers of the digestive tract are very different, accurate diagnosis is important. Researchers have made great progress in developing tests that can detect specific substances found in the cells of carcinoid tumors but not other cancers. Most of these tests involve treating tissue samples with special antibodies produced in the lab. The antibodies are designed to recognize specific substances that appear only in certain types of tumors.

OctreoScan is an imaging test commonly used to look for neuroendocrine tumors/cancers in the body. Researchers are now looking at other radionuclide methods to see if they can detect carcinoid tumors early.

Treatment

Surgery is the main treatment option for carcinoid tumors when possible. But better approaches are needed when surgery can't remove all of the tumors. Chemotherapy has had limited success against this disease. New chemotherapy drugs and combinations of drugs are being studied, but true advances against this disease are likely to come from other approaches.

Targeted therapy: Several newer types of drugs, known as targeted therapies, are now being studied for use against neuroendocrine tumors and cancers. These drugs are designed to attack some specific aspect of cancer cells. Bevacizumab (Avastin), for example, attacks a tumor's blood supply. It is already being used against some types of cancer and is being studied for carcinoid tumors.

Octreotide is the drug most commonly used to help treat symptoms of the carcinoid syndrome, but it doesn't work for everybody. Researchers are now looking at related drugs, such as pasireotide, which may be more potent and may help more people.

Radionuclide scans, such as the I-131 MIBG scan, can be helpful in finding neuroendocrine cancers because they use substances that are attracted to neuroendocrine cells. These substances are attached to slightly radioactive elements so that they can be detected with special cameras. But doctors are now exploring the idea of attaching them to elements with higher levels of radioactivity. When injected into the body, the substance (such as MIBG) would deliver the radioactivity directly to the tumors, where the radiation given off could kill the tumor cells. This approach is available in Europe and is now being studied in the United States.

Last Medical Review: 06/19/2009
Last Revised: 06/19/2009