Spatiotemporal heterogeneity and clinical challenge of pancreatic neuroendocrine tumors

Xin Lou; Yi Qin; Xiaowu Xu; Xianjun Yu; Shunrong Ji

doi:10.1016/j.bbcan.2022.188782

Spatiotemporal heterogeneity and clinical challenge of pancreatic neuroendocrine tumors

Biochim Biophys Acta Rev Cancer. 2022 Sep;1877(5):188782. doi: 10.1016/j.bbcan.2022.188782. Epub 2022 Aug 24.

Authors

Xin Lou¹, Yi Qin¹, Xiaowu Xu², Xianjun Yu³, Shunrong Ji⁴

Affiliations

¹ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Pancreatic Cancer Institute, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China.
² Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Pancreatic Cancer Institute, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. Electronic address: xuxiaowu@fudanpci.org.
³ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Pancreatic Cancer Institute, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. Electronic address: yuxianjun@fudanpci.org.
⁴ Center for Neuroendocrine Tumors, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Shanghai Pancreatic Cancer Institute, Shanghai 200032, China; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China. Electronic address: jishunrong@fudanpci.org.

PMID: 36028148
DOI: 10.1016/j.bbcan.2022.188782

Abstract

During the course of pancreatic neuroendocrine tumors (NETs), they generally become more heterogeneous with individual cells exhibiting distinct molecular fingerprints. This heterogeneity manifests itself through an unequal distribution of genetically-variant, tumor cell subpopulations within disease locations (i.e., spatial heterogeneity) or changes in the genomic landscape over time (i.e., temporal heterogeneity); these characteristics complicate clinical diagnosis and treatment. Effective, feasible tumor heterogeneity detection and eradication methods are essential to overcome the clinical challenges of pancreatic NETs. This review explores the molecular fingerprints of pancreatic NETs and the spectrum of tumoral heterogeneity. We then describe the challenges of assessing heterogeneity by liquid biopsies and imaging modalities and the therapeutic challenges for pancreatic NETs. In general, navigating these challenges, refining approaches for translational research, and ultimately improving patient care are available once we have a better understanding of intratumoral spatiotemporal heterogeneity.

Keywords: Clinical challenge; Molecular landscape; Pancreatic NETs; Spatial heterogeneity; Temporal heterogeneity.

Publication types

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

MeSH terms

Humans
Neuroendocrine Tumors* / pathology
Pancreatic Neoplasms* / diagnosis
Pancreatic Neoplasms* / genetics
Radiopharmaceuticals

Substances

Radiopharmaceuticals