Udhayvir Grewal: NANETS Guidelines on Management of NEC – A Very Tough-to-Treat Disease
Udhayvir Grewal, Resident Physician at Ochsner LSU Health Shreveport Academy Medical Centre, shared a post on X by Julie Hallet, Director of Research at the Canadian Society of Surgical Oncology (CSSO) and President of the Society of Surgical Ergonomics, adding:
“NANETS guideline on management of NEC.
A very tough to treat disease.
- Platinum chemo upfront is the SOC (sobering results however).
- No role for IO outside of clinical trials unless TMB-H (only more than 20 on tissue gets me excited) or MSI-H
- Molecular profiling is a MUST (both tissue and liquid, low threshold for repeating testing at progression)
- Consider testing for all tissue agnostic alterations, including HER2
- Several trials in this space- refer early!!! DLL3, SEZ6,DLK1,Trop2, SSTR2- many novel targets for ADCs, novel cellular therapies, RLTs, etc.”
Quoting Julie Hallet’s post about a paper by Jennifer R. Eads et al., published in Endocrine-Related Cancer:
“Following expert statement for G3 NETs, here is some guidance for NEC (carcinoma) from NANETS
Aggressive and fast-growing cancers require different therapy than NETs.
- Loc – rare surgery for R0 with chemotherapy
- 1st-line – Platinum+etoposide, recurrence >6m – platinum vs <6m – alternate chemotherapy
- IO – not routine, for MSI/dMMR or TMB-high”
Title: Expert Consensus Practice Recommendations of the North American Neuroendocrine Tumor Society for the management of high grade gastroenteropancreatic and gynecologic neuroendocrine neoplasms
Authors: Jennifer R Eads, Thorvardur R Halfdanarson, Tim Asmis, Andrew M Bellizzi, Emily K Bergsland, Arvind Dasari, Ghassan El-Haddad, Michael Frumovitz, Joshua Meyer, Erik Mittra, Sten Myrehaug, Eric Nakakura, Nitya Raj, Heloisa P Soares, Brian Untch, Namrata Vijayvergia, Jennifer A Chan
You can read the Full Article on Endocrine-Related Cancer.
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