What’s New in Pancreatic Neuroendocrine Tumor Research?

Research into the causes, diagnosis, and treatment of pancreatic neuroendocrine tumor (NET) is being done 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. Scientists have found changes in the MEN1, VHL, NF1, and TSC genes 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. Traditionally, pancreatic surgery is done through a large incision (cut) down the middle of the belly. However, minimally invasive surgery, such as laparoscopic or robotic-based surgeries, is becoming more common. Research is continuing on how best to remove pancreatic tumors.

Chemotherapy

At present, there is not much data on effective treatment with chemo. Only a few chemo regimens have been found to be helpful and are given to patients usually to reduce the size of the tumor and improve symptoms. Research is being done to find more chemo options.

Immunotherapy

Immunotherapy is treatment that uses a person's own immune system to fight cancer. The use of checkpoint inhibitors (a form of immunotherapy) has become an important part in treating certain cancers. Checkpoint inhibitors take the "brakes" off a person's immune system, which helps it recognize and attack cancer cells. Research suggests that a type of checkpoint inhibitor, called the PD-1 inhibitor, may be effective in treating pancreatic NETs. Furthermore, it might be more effective when it is combined with a targeted therapy, such as bevacizumab. However, more research is needed to better understand if this can be a treatment option.

Targeted therapy

Targeted drugs work differently from standard chemo drugs in that they attack only specific proteins on cancer cells (or nearby cells). Their side effects are different from traditional side effects of chemo drugs. Targeted therapies, such as everolimus and sunitinib, are already approved to manage advanced pancreatic NET. Looking for new targets to attack is an active area of cancer research.