Bronchopulmonary Neuroendocrine Neoplasms (BP NEN) – Ronny Allan

Tag: Bronchopulmonary Neuroendocrine Neoplasms (BP NEN)

Bronchopulmonary neuroendocrine neoplasms (BP NENs) encompass a wide spectrum of pathologically and clinically distinct entities which include (well-differentiated) ‘typical’ and ‘atypical’ NETs and Large and Small Cell Neuroendocrine Carcinomas (poorly differentiated). Together they make up around 20% of all cancers of the Lung and are the most common type of Neuroendocrine Neoplasm.

BP NETs comprise the well differentiated types of BP NENs

Typical NETs are predominantly centrally located. Metastases are unusual. but can appear late in the course of the disease. Atypical Lung NETs have sometimes been misinterpreted as “early oat cell carcinomas”. These tumors are most often peripheral and metastases are frequent. Lung neuroendocrine Carcinomas have an aggressive course and are poorly differentiated.

Some texts may include the term moderately differentiated in relation to atypical Lung NETs in line with lung cancer classification.

Somatostatin Receptor Positive Advanced Bronchial Neuroendocrine Tumors – PRRT vs Everolimus

Clinical Trials and Research

US Trial I was delighted to see this clinical trial which looks at the efficacy of PRRT (Lu177 dotatate) vs the efficacy of Everolimus (Afinitor). The latter is approved for the treatment of adult patients with progressive, well-differentiated non-functional, neuroendocrine tumors (NET) of gastrointestinal (GI) or lung origin with unresectable, locally advanced or metastatic disease (US FDA wording, Europe is similar). What is this trial? This phase II trial studies the effect of lutetium Lu 177 dotatate compared to the usual treatment (everolimus) in treating patients with somatostatin receptor positive bronchial neuroendocrine tumors that have spread to other places in the body (advanced). Radioactive drugs, such as lutetium Lu 177 dotatate, may carry radiation directly to tumor cells and may reduce harm to normal cells. Lutetium Lu 177 dotatate may…

29Jan 2023 by Ronny Allan No Comments

Dustin Diamond

Awareness

I'm behind the curve on this one after being ahead on celebrities such as Steve Jobs, Aretha Franklin, Wilko Johnson and Olivia Williams. But in my defence, Dustin Diamond was not that well known in UK. I noticed his name mentioned in relation to "Neuroendocrine" in early 2023. I set about searching and it didn't take me long to make a connection. BUT .... this is much more complex than the cases above despite the misinformation which followed in all of these cases due to the use of anatomy to name cancers. This appears to be a common issue, particularly as it is the language used by doctors and the press to simplify the complexity to which I refer above; and will outline below. Who is Dustin Diamond Dustin Neil…

25Feb 2020 by Ronny Allan 1 Comment

Clinical Trial: Lu-177 DOTATOC (PRRT) in adult subjects with Somatostatin receptor (SSTR) positive Pulmonary, Pheochromocytoma, Paraganglioma, Unknown primary, and Thymic Neuroendocrine Tumors

Clinical Trials and Research

Excellent news for those who don't have Gastroenteropancreatic NETs (GEP-NETs). A trial of PRRT is being set-up for the less common types of NET including those with an unknown primary. Using the DOTATOC radionuclide rather than the Lutathera model of using DOTATATE, this trial will cater for Pulmonary, Pheochromoctyoma, Paraganlioma, Unknown Primary and Thymic Neuroendocrine Tumours.Excel Diagnostics and Nuclear Oncology Center (EDNOC) announced today that its physician sponsored Investigational New Drug (IND) application to evaluate safety and efficacy of Lu-177 DOTATOC in adult subjects with Somatostatin receptor (SSTR) expressing Pulmonary, Pheochromocytoma, Paraganglioma, Unknown primary, and Thymic Neuroendocrine Tumors (PUT-NET), has received approval to proceed by USA Food and Drug Administration (FDA) and also charge authorization has been granted (IND#143631, NCT04276597). This IND is anticipated to start enrolling patients by early…

17Sep 2018 by Ronny Allan 2 Comments

Don’t worry, it’s benign!

Awareness, Living with Neuroendocrine Cancer, Patient Advocacy

OPINIONOne of the most controversial aspects of Neuroendocrine Tumours (NETs) is the ‘benign vs malignant’ question. It’s been widely debated, and it frequently patrols the various patient forums and other social media platforms. It raises emotions and it triggers many responses ….. at least from those willing to engage in the conversation. At best, this issue can cause confusion, at worst, it might contradict what new patients have been told by their physicians (….or not been told). This post will not cover Neuroendocrine Carcinoma which by standard cancer nomenclature definition is malignant.Any standard cancer nomenclature definition of the word 'tumour' will confirm the definition of the word tumour means it can either be benign or malignant. However, and while I'm sure there are benign NETs, the key statement to explain…