Integrating Functional Imaging and Molecular Profiling for Optimal Treatment Selection in Neuroendocrine Neoplasms (NEN)

Grace Kong; Emma Boehm; Owen Prall; William K Murray; Richard W Tothill; Michael Michael

doi:10.1007/s11912-023-01381-w

Integrating Functional Imaging and Molecular Profiling for Optimal Treatment Selection in Neuroendocrine Neoplasms (NEN)

Curr Oncol Rep. 2023 May;25(5):465-478. doi: 10.1007/s11912-023-01381-w. Epub 2023 Feb 24.

Authors

Grace Kong^#^{1

2}, Emma Boehm^#^{3

4}, Owen Prall⁵, William K Murray⁵, Richard W Tothill^{6

4}, Michael Michael^{6

7}

Affiliations

¹ Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia. Grace.kong@petermac.org.
² The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia. Grace.kong@petermac.org.
³ Department of Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
⁴ Centre for Cancer Research and Department of Clinical Pathology, University of Melbourne, Melbourne, VIC, Australia.
⁵ Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
⁶ The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia.
⁷ Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

^# Contributed equally.

Abstract

Purpose of review: Gastroenteropancreatic NEN (GEP-NEN) are group of malignancies with significant clinical, anatomical and molecular heterogeneity. High-grade GEP-NEN in particular present unique management challenges.

Recent findings: In the current era, multidisciplinary management with access to a combination of functional imaging and targeted molecular profiling can provide important disease characterisation, guide individualised management and improve patient outcome. Multiple treatment options are now available, and combination and novel therapies are being explored in clinical trials. Precision medicine is highly relevant for a heterogenous disease like NEN. The integration of dual-tracer functional PET/CT imaging, molecular histopathology and genomic data has the potential to be used to gain a more comprehensive understanding of an individual patient's disease biology for precision diagnosis, prognostication and optimal treatment allocation.

Keywords: Functional imaging; Genomics; Molecular profile; Neuroendocrine neoplasms (NEN); Neuroendocrine tumors (NET); PET/CT.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Gastrointestinal Neoplasms* / diagnostic imaging
Gastrointestinal Neoplasms* / genetics
Gastrointestinal Neoplasms* / therapy
Humans
Intestinal Neoplasms* / diagnostic imaging
Intestinal Neoplasms* / genetics
Intestinal Neoplasms* / therapy
Neuroendocrine Tumors* / diagnostic imaging
Neuroendocrine Tumors* / genetics
Neuroendocrine Tumors* / therapy
Pancreatic Neoplasms* / diagnostic imaging
Pancreatic Neoplasms* / genetics
Pancreatic Neoplasms* / therapy
Positron Emission Tomography Computed Tomography
Stomach Neoplasms* / diagnostic imaging
Stomach Neoplasms* / genetics
Stomach Neoplasms* / therapy