What’s New in Pancreatic Neuroendocrine Tumor Research?

Research into the causes, diagnosis, and treatment of pancreatic neuroendocrine tumor (NET) is under way in many medical centers throughout the world.

Genetics and early detection

Researchers are looking for the causes of pancreatic NETs in the hope that this knowledge can be used to help prevent or treat them 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 pancreatic NETs. Other genetic changes that seem to make tumors more aggressive are now being explored as well.

Treatment

Surgery is the main treatment option for pancreatic NETs when possible. But better approaches are needed when surgery can’t remove all the tumors. New chemotherapy drugs and combinations of drugs are being studied as well as targeted therapy.

Chemotherapy

Temozolomide is known to be helpful in people with advanced pancreatic NET. New research shows temozolomide works better on tumors that are deficient in a certain DNA-repairing protein called O6-methylguanine-methyltransferase (MGMT). New studies have also shown that using another chemotherapy drug called capecitabine along with temozolomide helped people with advanced pancreatic NET live longer than people treated with temozolomide by itself.

Targeted therapies

Targeted drugs work differently from standard chemo drugs in that they attack only specific targets on cancer cells (or nearby cells). Targeted therapies may prove to be useful along with, or instead of, current treatments. They have different side effects than traditional chemo drugs. Looking for new targets to attack is an active area of cancer research.

Kinase inhibitors: Sunitinib and everolimus have shown to be helpful in pancreatic NETs.  Another kinase inhibitor, cabozantinib, also looks promising and more research is being done. Other kinase inhibitors, such as axitinib, nintedanib, pazopanib, and sulfatinib, are being studied as well. 

Anti-angiogenesis factors: All cancers depend on new blood vessels to nourish their growth. To block the growth of these vessels and thereby starve the tumor, scientists have developed anti-angiogenesis drugs. These are being studied in clinical trials for patients with pancreatic NETs.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Chan JA, Faris JE, Murphy JE, et al. Phase II trial of cabozantinib in patients with carcinoid and pancreatic neuroendocrine tumors. 2017 Gastrointestinal Cancers Symposium. Abstract 228. Presented January 20, 2017.

Grillo F, Florio T, Ferraù F, et al. Emerging multitarget tyrosine kinase inhibitors in the treatment of neuroendocrine neoplasms. Endocr Relat Cancer. 2018 Sep;25(9):R453-R466. doi: 10.1530/ERC-17-0531. Epub 2018 May 16.

Kulke MH, Hornick JL, Frauenhoffer C, et al: O6-methylguanine DNA methyltransferase deficiency and response to temozolomide-based therapy in patients with neuroendocrine tumors. Clin Cancer Res 15:338-345, 2009.

Kunz PL, Catalano PJ, Nimeiri H, et al: A randomized study of temozolomide or temozolomide and capecitabine in patients with advanced pancreatic neuroendocrine tumors: A trial of the ECOG-ACRIN Cancer Research Group (E2211). 2018 ASCO Annual Meeting. Abstract 4004. Presented June 4, 2018.

Walter T, van Brakel B, Vercherat C, et al. O6-Methylguanine-DNA methyltransferase status in neuroendocrine tumours: prognostic relevance and association with response to alkylating agents. British Journal of Cancer. 2015;112(3):523-531. doi:10.1038/bjc.2014.660.

Last Medical Review: October 30, 2018 Last Revised: October 30, 2018

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